Background and Aim Persistent pulmonary hypertension (PPHN) is a life-threatening condition treated with high oxygen concentrations in inspired air (fiO2). Little is known about the course of cerebral oxygen saturation (rcSO2) and extraction (FTOE) in neonates with PPHN. Our aim is to explore the course of rcSO2 and FTOE in neonates with PPHN during the first 72 hours of life.
Methods In term neonates with PPHN rcSO2 was measured with near-infrared spectroscopy. Simultaneously, arterial oxygen saturation (SpO2) was measured and FTOE was calculated:(SpO2-rcSO2)/SpO2. We obtained clinical factors such as pH, pCO2, blood pressure, NO-therapy, sedatives and inotropics. We used Wilcoxon test and Spearman’s correlation to test significance.
Results We included six neonates (median GA 40+2wk, BW 3900g). RcSO2 increased from day 1 to day 2 (p=0.028) and FTOE decreased from day 1 to day 2 (p=0.027).
Clinical factors were not associated with rcSO2 and FTOE, but rcSO2 was nearly significantly positively associated with midazolam at day 2 (p=0.05), and negatively with pCO2 at day 3 (p=0.051).
Conclusions Highest RcSO2-values and lowest FTOE-values were seen on day two, suggesting decreased oxygen consumption, possibly as a consequence of midazolam treatment. Even so, treatment with high fiO2 did not lead to high levels of oxygen in brain tissue in most infants.