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The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates

Background: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of su...

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Autores Principales:	Smits, A., Thewissen, L., Dereymaeker, A., Dempsey, E., Caicedo, A., Naulaers, G.
Formato:	Artículo (Article)
Lenguaje:	Inglés (English)
Publicado:	Bentham Science Publishers 2017
Materias:	Pharmacodynamics Neonate Monitoring Hemodynamics Cerebral activity Central nervous system
Acceso en línea:	https://repository.urosario.edu.co/handle/10336/27107 https://doi.org/10.2174/1381612823666170918124419

id	ir-10336-27107
recordtype	dspace
spelling	ir-10336-271072020-08-19T14:41:01Z The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates El uso de monitorización hemodinámica y cerebral para estudiar la farmacodinámica en recién nacidos Smits, A. Thewissen, L. Dereymaeker, A. Dempsey, E. Caicedo, A. Naulaers, G. Pharmacodynamics Neonate Monitoring Hemodynamics Cerebral activity Central nervous system Background: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. Methods: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates. Results: The use of blood pressure measurements, heart rate variability, functional echocardiography, nearinfrared spectroscopy and (amplitude-integrated) electroencephalography in neonates is discussed, as well as new parameters introduced by these tools. Based on the ‘brain circulation model’, the hemodynamic effects on the brain and their interplay are summarized. In this model, 3 processes (i.e. blood processes, vascular smooth muscle processes and tissue processes) and 3 mechanisms (i.e. autoregulation, blood flow metabolism coupling and cerebral oxygen balance) are distinguished, which all may be influenced by drug administration. Finally, propofol, sevoflurane, midazolam and inotropes are used as examples of which PD has been studied using the available hemodynamic and/or cerebral monitoring tools. Conclusion: The implementation of (non-)invasive monitoring tools to document hemodynamic and cerebral PD effects in neonates is of relevance both in a neonatal research and intensive clinical care setting. We highlight the need to integrate these tools in future PD research. Furthermore, besides short-term drug effects, long-term outcome of drug therapy in neonates also warrants further attention. 2017 2020-08-19T14:41:01Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion ISSN: 1381-6128 EISSN: 1873-4286 https://repository.urosario.edu.co/handle/10336/27107 https://doi.org/10.2174/1381612823666170918124419 eng info:eu-repo/semantics/restrictedAccess application/pdf Bentham Science Publishers Current Pharmaceutical Design
institution	EdocUR - Universidad del Rosario
collection	DSpace
language	Inglés (English)
topic	Pharmacodynamics Neonate Monitoring Hemodynamics Cerebral activity Central nervous system
spellingShingle	Pharmacodynamics Neonate Monitoring Hemodynamics Cerebral activity Central nervous system Smits, A. Thewissen, L. Dereymaeker, A. Dempsey, E. Caicedo, A. Naulaers, G. The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
description	Background: Drugs acting on the cardiovascular and central nervous system often display relatively fast clinical responses, which may differ in neonates compared to children and adults. Introduction of bedside monitoring tools might be of additional value in the pharmacodynamic (PD) assessment of such drugs in neonates. Methods: We aim to provide an overview of the frequently used monitoring tools to assess drug effects on the hemodynamic status as well as the cerebral circulation, oxygenation and cerebral metabolism in neonates. Results: The use of blood pressure measurements, heart rate variability, functional echocardiography, nearinfrared spectroscopy and (amplitude-integrated) electroencephalography in neonates is discussed, as well as new parameters introduced by these tools. Based on the ‘brain circulation model’, the hemodynamic effects on the brain and their interplay are summarized. In this model, 3 processes (i.e. blood processes, vascular smooth muscle processes and tissue processes) and 3 mechanisms (i.e. autoregulation, blood flow metabolism coupling and cerebral oxygen balance) are distinguished, which all may be influenced by drug administration. Finally, propofol, sevoflurane, midazolam and inotropes are used as examples of which PD has been studied using the available hemodynamic and/or cerebral monitoring tools. Conclusion: The implementation of (non-)invasive monitoring tools to document hemodynamic and cerebral PD effects in neonates is of relevance both in a neonatal research and intensive clinical care setting. We highlight the need to integrate these tools in future PD research. Furthermore, besides short-term drug effects, long-term outcome of drug therapy in neonates also warrants further attention.
format	Artículo (Article)
author	Smits, A. Thewissen, L. Dereymaeker, A. Dempsey, E. Caicedo, A. Naulaers, G.
author_facet	Smits, A. Thewissen, L. Dereymaeker, A. Dempsey, E. Caicedo, A. Naulaers, G.
author_sort	Smits, A.
title	The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
title_short	The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
title_full	The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
title_fullStr	The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
title_full_unstemmed	The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
title_sort	use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates
publisher	Bentham Science Publishers
publishDate	2017
url	https://repository.urosario.edu.co/handle/10336/27107 https://doi.org/10.2174/1381612823666170918124419
_version_	1676074223766863872
score	12,131701

The use of hemodynamic and cerebral monitoring to study pharmacodynamics in neonates

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