Article Text

CEREBRAL OXYGENATION IN PRETERM INFANTS AND NEURODEVELOPMENTAL OUTCOME
  1. N E van der Aa1,
  2. P M Lemmers1,
  3. I C van Haastert1,
  4. F van Bel1,
  5. P Steendijk2
  1. 1Department of Neonatology, Wilhelmina Children’s Hospital, Utrecht, The Netherlands,
  2. 2Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands

Abstract

Background: Suboptimal cerebral oxygenation plays an important role in the aetiology of brain lesions in preterm infants. Near-infrared spectroscopy (NIRS) has been proved to monitor cerebral oxygenation reliably.

Objective: To determine the value of NIRS-monitored regional cerebral oxygen saturation (rScO2) in relation to outcome in preterm infants.

Design and Methods: Seventy infants (gestational age <32 weeks) were monitored by NIRS during the first 72 h after birth. Thirty-nine (56%) fulfilled the study criteria. At the corrected age of 24 months neurodevelopmental outcome was determined with the Bayley scales of infant development (BSID-II), which includes a mental and psychomotor development index (MDI and PDI). Suboptimal neurodevelopmental outcome was defined as a BSID score <85. The correlation between rScO2, PDI and MDI was calculated for each day separately and overall.

Results: rScO2 on day 1 was higher in infants with suboptimal neurodevelopmental outcome (PDI p<0.001, MDI p<0.005). rScO2 on day 1 was significantly related to PDI (r  =  −0.43, p<0.01) and MDI (r  =  −0.33, p<0.05). No relations were found for days 2 or 3.

Conclusion: Higher rScO2 values during the first day of life in very preterm infants were correlated with suboptimal neurodevelopmental outcome.

Figure 1

van der Aa et al rScO2, regional cerebral oxygen saturation.

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