Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial

Isabel Benavente-Fernández; Sylke J Steggerda; Kian D Liem; Simón Lubián-López; Linda S de Vries

doi:10.1016/j.jpeds.2023.113578

Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial

Isabel Benavente-Fernández
, Sylke J Steggerda
, Kian D Liem
, Simón Lubián-López
, Linda S de Vries

Birth Center Neonatology - Medical

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVE: To study the potential role of ventricular volume (VV) estimation in the management of posthemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP)-shunt insertion and 2-year neurodevelopmental outcome in infants born preterm.

STUDY DESIGN: We included 59 patients from the Early vs Late Ventricular Intervention Study from 4 participating centers. VV was manually segmented in 209 3-dimensional ultrasound scans and estimated from 2-dimensional ultrasound linear measurements in a total of 1226 ultrasounds. We studied the association of both linear measurements and VV to the need for VP shunt and 2-year neurodevelopmental outcome in the overall cohort and in the 29 infants who needed insertion of a reservoir. We used general estimating equations to account for repeated measures per individual.

RESULTS: Maximum pre-reservoir VV (β coefficient = 0.185, P = .0001) and gestational age at birth (β = -0.338; P = .0001) were related to the need for VP shunt. The estimated optimal single VV measurement cut point of 17 cm 3 correctly classified 79.31% with an area under the curve of 0.76 (CI 95% 0.74-0.79). Maximum VV (β = 0.027; P = .012) together with VP shunt insertion (β = 3.773; P = .007) and gestational age (β = -0.273; P = .0001) were related to cognitive outcome at 2 years. Maximum ventricular index and anterior horn width before reservoir insertion were independently associated with the need of VP shunt and the proposed threshold groups in the Early vs Late Ventricular Intervention Study trial were associated with long-term outcome.

CONCLUSIONS: Pre-reservoir VV measurements were associated with the need for VP-shunt insertion and 2-year cognitive outcome among infants born preterm with posthemorrhagic ventricular dilatation.

TRIAL REGISTRATION: ISRCTN43171322.

Original language	English
Article number	113578
Pages (from-to)	1-8
Journal	The Journal of Pediatrics
Volume	261
Early online date	22 Jun 2023
DOIs	https://doi.org/10.1016/j.jpeds.2023.113578
Publication status	Published - Oct 2023

Keywords

brain ultrasonography
preterm infant
ventricular dilatation
ventricular volume

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Benavente-Fernández, I., Steggerda, S. J., Liem, K. D., Lubián-López, S., & de Vries, L. S. (2023). Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial. The Journal of Pediatrics, 261, 1-8. Article 113578. https://doi.org/10.1016/j.jpeds.2023.113578

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title = "Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial",

abstract = "OBJECTIVE: To study the potential role of ventricular volume (VV) estimation in the management of posthemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP)-shunt insertion and 2-year neurodevelopmental outcome in infants born preterm.STUDY DESIGN: We included 59 patients from the Early vs Late Ventricular Intervention Study from 4 participating centers. VV was manually segmented in 209 3-dimensional ultrasound scans and estimated from 2-dimensional ultrasound linear measurements in a total of 1226 ultrasounds. We studied the association of both linear measurements and VV to the need for VP shunt and 2-year neurodevelopmental outcome in the overall cohort and in the 29 infants who needed insertion of a reservoir. We used general estimating equations to account for repeated measures per individual.RESULTS: Maximum pre-reservoir VV (β coefficient = 0.185, P = .0001) and gestational age at birth (β = -0.338; P = .0001) were related to the need for VP shunt. The estimated optimal single VV measurement cut point of 17 cm 3 correctly classified 79.31\% with an area under the curve of 0.76 (CI 95\% 0.74-0.79). Maximum VV (β = 0.027; P = .012) together with VP shunt insertion (β = 3.773; P = .007) and gestational age (β = -0.273; P = .0001) were related to cognitive outcome at 2 years. Maximum ventricular index and anterior horn width before reservoir insertion were independently associated with the need of VP shunt and the proposed threshold groups in the Early vs Late Ventricular Intervention Study trial were associated with long-term outcome. CONCLUSIONS: Pre-reservoir VV measurements were associated with the need for VP-shunt insertion and 2-year cognitive outcome among infants born preterm with posthemorrhagic ventricular dilatation.TRIAL REGISTRATION: ISRCTN43171322.",

keywords = "brain ultrasonography, preterm infant, ventricular dilatation, ventricular volume",

author = "Isabel Benavente-Fern{\'a}ndez and Steggerda, \{Sylke J\} and Liem, \{Kian D\} and Sim{\'o}n Lubi{\'a}n-L{\'o}pez and \{de Vries\}, \{Linda S\}",

note = "Funding Information: I.B. received a grant from the Spanish Neonatology Society (SENeo-research projects grants 2021). No other disclosures are reported. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors declare no conflicts of interest. Publisher Copyright: {\textcopyright} 2023 The Author(s)",

year = "2023",

month = oct,

doi = "10.1016/j.jpeds.2023.113578",

language = "English",

volume = "261",

pages = "1--8",

journal = "The Journal of Pediatrics",

issn = "0022-3476",

publisher = "Elsevier",

}

Benavente-Fernández, I, Steggerda, SJ, Liem, KD, Lubián-López, S & de Vries, LS 2023, 'Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial', The Journal of Pediatrics, vol. 261, 113578, pp. 1-8. https://doi.org/10.1016/j.jpeds.2023.113578

Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial. / Benavente-Fernández, Isabel; Steggerda, Sylke J; Liem, Kian D et al.
In: The Journal of Pediatrics, Vol. 261, 113578, 10.2023, p. 1-8.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation

T2 - A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial

AU - Benavente-Fernández, Isabel

AU - Steggerda, Sylke J

AU - Liem, Kian D

AU - Lubián-López, Simón

AU - de Vries, Linda S

N1 - Funding Information: I.B. received a grant from the Spanish Neonatology Society (SENeo-research projects grants 2021). No other disclosures are reported. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors declare no conflicts of interest. Publisher Copyright: © 2023 The Author(s)

PY - 2023/10

Y1 - 2023/10

N2 - OBJECTIVE: To study the potential role of ventricular volume (VV) estimation in the management of posthemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP)-shunt insertion and 2-year neurodevelopmental outcome in infants born preterm.STUDY DESIGN: We included 59 patients from the Early vs Late Ventricular Intervention Study from 4 participating centers. VV was manually segmented in 209 3-dimensional ultrasound scans and estimated from 2-dimensional ultrasound linear measurements in a total of 1226 ultrasounds. We studied the association of both linear measurements and VV to the need for VP shunt and 2-year neurodevelopmental outcome in the overall cohort and in the 29 infants who needed insertion of a reservoir. We used general estimating equations to account for repeated measures per individual.RESULTS: Maximum pre-reservoir VV (β coefficient = 0.185, P = .0001) and gestational age at birth (β = -0.338; P = .0001) were related to the need for VP shunt. The estimated optimal single VV measurement cut point of 17 cm 3 correctly classified 79.31% with an area under the curve of 0.76 (CI 95% 0.74-0.79). Maximum VV (β = 0.027; P = .012) together with VP shunt insertion (β = 3.773; P = .007) and gestational age (β = -0.273; P = .0001) were related to cognitive outcome at 2 years. Maximum ventricular index and anterior horn width before reservoir insertion were independently associated with the need of VP shunt and the proposed threshold groups in the Early vs Late Ventricular Intervention Study trial were associated with long-term outcome. CONCLUSIONS: Pre-reservoir VV measurements were associated with the need for VP-shunt insertion and 2-year cognitive outcome among infants born preterm with posthemorrhagic ventricular dilatation.TRIAL REGISTRATION: ISRCTN43171322.

AB - OBJECTIVE: To study the potential role of ventricular volume (VV) estimation in the management of posthemorrhagic ventricular dilatation related to the need for ventriculoperitoneal (VP)-shunt insertion and 2-year neurodevelopmental outcome in infants born preterm.STUDY DESIGN: We included 59 patients from the Early vs Late Ventricular Intervention Study from 4 participating centers. VV was manually segmented in 209 3-dimensional ultrasound scans and estimated from 2-dimensional ultrasound linear measurements in a total of 1226 ultrasounds. We studied the association of both linear measurements and VV to the need for VP shunt and 2-year neurodevelopmental outcome in the overall cohort and in the 29 infants who needed insertion of a reservoir. We used general estimating equations to account for repeated measures per individual.RESULTS: Maximum pre-reservoir VV (β coefficient = 0.185, P = .0001) and gestational age at birth (β = -0.338; P = .0001) were related to the need for VP shunt. The estimated optimal single VV measurement cut point of 17 cm 3 correctly classified 79.31% with an area under the curve of 0.76 (CI 95% 0.74-0.79). Maximum VV (β = 0.027; P = .012) together with VP shunt insertion (β = 3.773; P = .007) and gestational age (β = -0.273; P = .0001) were related to cognitive outcome at 2 years. Maximum ventricular index and anterior horn width before reservoir insertion were independently associated with the need of VP shunt and the proposed threshold groups in the Early vs Late Ventricular Intervention Study trial were associated with long-term outcome. CONCLUSIONS: Pre-reservoir VV measurements were associated with the need for VP-shunt insertion and 2-year cognitive outcome among infants born preterm with posthemorrhagic ventricular dilatation.TRIAL REGISTRATION: ISRCTN43171322.

KW - brain ultrasonography

KW - preterm infant

KW - ventricular dilatation

KW - ventricular volume

UR - https://www.scopus.com/pages/publications/85165719658

U2 - 10.1016/j.jpeds.2023.113578

DO - 10.1016/j.jpeds.2023.113578

M3 - Article

C2 - 37353143

SN - 0022-3476

VL - 261

SP - 1

EP - 8

JO - The Journal of Pediatrics

JF - The Journal of Pediatrics

M1 - 113578

ER -

Benavente-Fernández I, Steggerda SJ, Liem KD, Lubián-López S, de Vries LS. Ultrasonographic Estimation of Ventricular Volume in Infants Born Preterm with Post- hemorrhagic Ventricular Dilatation: A Nested Substudy of the Randomized Controlled Early Versus Late Ventricular Intervention Study (ELVIS) Trial. The Journal of Pediatrics. 2023 Oct;261:1-8. 113578. Epub 2023 Jun 22. doi: 10.1016/j.jpeds.2023.113578