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Morphine affects brain activity and volumes in preterms : An observational multi-center study

Tataranno, M. L. ; Gui, L. ; Hellström-Westas, L. LU ; Toet, M. ; Groenendaal, F. ; Claessens, N. H.P. ; Schuurmans, J. ; Fellman, V. LU ; Sävman, K. and de Vries, L. S. , et al. (2020) In Early Human Development 144.
Abstract

Objective: We hypothesized that morphine has a depressing effect on early brain activity, assessed using quantitative aEEG/EEG parameter and depressed activity will be associated with brain volumes at term in extremely preterm infants. Study design: 174 preterm infants were enrolled in 3 European tertiary NICUs (mean GA:26 ± 1wks) and monitored during the first 72 h after birth with continuous 2 channel aEEG. Six epochs of aEEG recordings were selected and minimum amplitude of aEEG (min aEEG), percentage of time amplitude <5 μV (% of time < 5 μV), spontaneous activity transients (SATrate) and interSAT interval (ISI) were calculated. For infants receiving morphine, the cumulative morphine dosage was calculated. In a subgroup of 58... (More)

Objective: We hypothesized that morphine has a depressing effect on early brain activity, assessed using quantitative aEEG/EEG parameter and depressed activity will be associated with brain volumes at term in extremely preterm infants. Study design: 174 preterm infants were enrolled in 3 European tertiary NICUs (mean GA:26 ± 1wks) and monitored during the first 72 h after birth with continuous 2 channel aEEG. Six epochs of aEEG recordings were selected and minimum amplitude of aEEG (min aEEG), percentage of time amplitude <5 μV (% of time < 5 μV), spontaneous activity transients (SATrate) and interSAT interval (ISI) were calculated. For infants receiving morphine, the cumulative morphine dosage was calculated. In a subgroup of 58 infants, good quality MRI at term equivalent age (TEA) and the cumulative morphine dose until TEA were available. The effects of morphine administration and cumulative dose on aEEG/EEG measures and on brain volumes were investigated. Results: Morphine administration had a significant effect on all quantitative aEEG/EEG measures, causing depression of early brain activity [longer ISI (β 2.900), reduced SAT rate (β −1.386), decreased min aEEG (β −0.782), and increased % of time < 5 μV (β 14.802)] in all epochs. A significant effect of GA and postnatal age on aEEG/EEG measures was observed. Cumulative morphine dose until TEA had a significant negative effect on total brain volume (TBV) (β −8.066) and cerebellar volume (β −1.080). Conclusions: Administration of sedative drugs should be considered when interpreting aEEG/EEG together with the negative dose dependent morphine impact on brain development.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Brain volumes, Morphine, Neonatal aEEG/EEG, Preterm infants
in
Early Human Development
volume
144
article number
104970
publisher
Elsevier
external identifiers
  • pmid:32276190
  • scopus:85082745376
ISSN
0378-3782
DOI
10.1016/j.earlhumdev.2020.104970
language
English
LU publication?
yes
id
b49dc296-20fd-4944-93fc-a3935862e963
date added to LUP
2020-04-16 16:57:25
date last changed
2020-04-22 05:54:56
@article{b49dc296-20fd-4944-93fc-a3935862e963,
  abstract     = {<p>Objective: We hypothesized that morphine has a depressing effect on early brain activity, assessed using quantitative aEEG/EEG parameter and depressed activity will be associated with brain volumes at term in extremely preterm infants. Study design: 174 preterm infants were enrolled in 3 European tertiary NICUs (mean GA:26 ± 1wks) and monitored during the first 72 h after birth with continuous 2 channel aEEG. Six epochs of aEEG recordings were selected and minimum amplitude of aEEG (min aEEG), percentage of time amplitude &lt;5 μV (% of time &lt; 5 μV), spontaneous activity transients (SATrate) and interSAT interval (ISI) were calculated. For infants receiving morphine, the cumulative morphine dosage was calculated. In a subgroup of 58 infants, good quality MRI at term equivalent age (TEA) and the cumulative morphine dose until TEA were available. The effects of morphine administration and cumulative dose on aEEG/EEG measures and on brain volumes were investigated. Results: Morphine administration had a significant effect on all quantitative aEEG/EEG measures, causing depression of early brain activity [longer ISI (β 2.900), reduced SAT rate (β −1.386), decreased min aEEG (β −0.782), and increased % of time &lt; 5 μV (β 14.802)] in all epochs. A significant effect of GA and postnatal age on aEEG/EEG measures was observed. Cumulative morphine dose until TEA had a significant negative effect on total brain volume (TBV) (β −8.066) and cerebellar volume (β −1.080). Conclusions: Administration of sedative drugs should be considered when interpreting aEEG/EEG together with the negative dose dependent morphine impact on brain development.</p>},
  author       = {Tataranno, M. L. and Gui, L. and Hellström-Westas, L. and Toet, M. and Groenendaal, F. and Claessens, N. H.P. and Schuurmans, J. and Fellman, V. and Sävman, K. and de Vries, L. S. and Huppi, P. and Benders, M. J.N.L.},
  issn         = {0378-3782},
  language     = {eng},
  publisher    = {Elsevier},
  series       = {Early Human Development},
  title        = {Morphine affects brain activity and volumes in preterms : An observational multi-center study},
  url          = {http://dx.doi.org/10.1016/j.earlhumdev.2020.104970},
  doi          = {10.1016/j.earlhumdev.2020.104970},
  volume       = {144},
  year         = {2020},
}