Abstract
Background: Preterm infants might have a disturbed cerebral autoregulation. An indirect way to monitor cerebral blood flow is by Near-Infrared Spectroscopy (NIRS). NIRS measures the regional cerebral tissue oxygenation (rcSO2). By combining rcSO2 with the transcutaneous arterial oxygenation (tcSaO2), the Fractional Tissue Oxygen Extraction (FTOE) can be calculated. In case of diminished cerebral blood flow, FTOE will increase.
Aim: To determine whether preterm infants have cerebral autoregulation.
Patients and Methods: In this observational study we included preterm infants < 32 weeks gestational age, in the first 72 hours after birth. For 24 hours, rcSO2, tcSaO2, and mean arterial pressure (MAP) were measured every five minutes, and FTOE was calculated: FTOE=(tcSaO2-rcSO2)/tcSaO2. Clinical data were collected (gestational age, birth weight, Apgar scores, Hb, PCO2, ventilation mode). Spearman's correlation coefficients were calculated in each individual patient to show absence of autoregulation, indicated by a significantly negative correlation between MAP and FTOE.
Results: We included 25 infants with a median gestational age of 28.8 weeks and a median birth weight of 1245 gram. In 10 infants we found a negative correlation (rho ranging from -0.432 to -0.156) between MAP and FTOE over 24 hours, suggesting absent autoregulation. None of the clinical variables influenced the presence or absence of autoregulation.
Conclusion: Cerebral autoregulation appears to be absent in almost half of the studied infants, suggested by the presence of a negative correlation between MAP and FTOE. We could not explain the presence or absence of autoregulation by clinical variables.
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Hummel, E., Kooi, E., Verhagen, E. et al. 592 Cerebral Autoregulation During 24 Hours in Preterm Infants Measured by Near-Infrared Spectroscopy. Pediatr Res 68 (Suppl 1), 303 (2010). https://doi.org/10.1203/00006450-201011001-00592
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DOI: https://doi.org/10.1203/00006450-201011001-00592
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