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Monitoring cerebral oxygenation of preterm infants using a neonatal specific sensor

Abstract

Introduction

Cerebral oxygenation (rcSO2) monitoring in preterm infants may identify periods of cerebral hypoxia or hyperoxia. We hypothesised that there was a relationship between rcSO2 values and short term outcome in infants of GA < 32weeks.

Methods

RcSO2 values were recorded for the first 48 h of life using an INVOS monitor with a neonatal sensor. The association between cranial ultrasound scan measured brain injury and rcSO2 was assessed.

Results

120 infants were included. Sixty-nine percent (83) of infants had a normal outcome (no IVH, no PVL, and survival at 1 month); less than one-quarter, 22% (26), had low grade IVH 1 or 2 (moderate outcome); and 9% (11) of infants had a severe outcome (IVH ≥ 3, PVL or died before 1 month age). rcSO2 values were lower for infants GA < 28weeks when compared with those GA 28–32, p < 0.001. There was no difference in absolute rcSO2 values between the three outcome groups but a greater degree of cerebral hypoxia was associated with preterm infants who had low grade 1 or 2 IVH.

Conclusion

Infants of GA < 28 weeks have lower cerebral oxygenation in the first 2 days of life. A greater degree of hypoxia was seen in infants with grade 1 or 2 haemorrhage. Normative ranges need to be gestation specific.

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Author contribution

MK conceptualised and designed the study, collected the data and drafted the initial manuscript. JMO carried out the initial data analysis and statistical analysis, and reviewed and revised the manuscript. GAH, WH, MW, and EL carried out the data collection, and reviewed and revised the manuscript. GBB critically reviewed and revised the manuscript. ACR and EMD supervised and helped design the study and data collection instrument and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Funding

This work was supported by the EU FP7/2007- 2013 under grant agreement no. 260777 (The HIP Trial). This study was also supported by a Science Foundation Ireland research Award (INFANT-12/RC/2272). JMO received financial support from the Irish Research Council (GOIPD/2014/396) and Science Foundation Ireland (15/SIRG/3580).

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Correspondence to E. M. Dempsey.

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The authors declare that they have no competing interests.

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Kenosi, M., O’Toole, J.M., Hawkes, G.A. et al. Monitoring cerebral oxygenation of preterm infants using a neonatal specific sensor. J Perinatol 38, 264–270 (2018). https://doi.org/10.1038/s41372-017-0007-5

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