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  • Clinical Research Article
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Cerebral oxygen saturation in neonates: a bedside comparison between neonatal and adult NIRS sensors

Pediatric Research volume 94, pages 1810–1816 (2023)Cite this article

Abstract

Background

The majority of neonatal NIRS literature recommends target ranges for cerebral saturation (rScO2) based on data using adult sensors. Neonatal sensors are now commonly used in the neonatal intensive care unit (NICU). However, there is limited clinical data correlating these two measurements of cerebral oxygenation.

Methods

A prospective observational study was conducted in two NICUs between November 2019 and May 2021. An adult sensor was placed on infants undergoing routine cerebral NIRS monitoring with a neonatal sensor. Time-synchronized rScO2 measurements from both sensors, heart rate, and systemic oxygen saturation values were collected over 6 h under varying clinical conditions and compared.

Results

Time-series data from 44 infants demonstrated higher rScO2 measurements with neonatal sensors than with adult sensors; however, the magnitude of the difference varied depending on the absolute value of rScO2 (Adult = 0.63 × Neonatal + 18.2). While there was an approximately 10% difference when adult sensors read 85%, readings were similar when adult sensors read 55%.

Conclusion

rScO2 measured by neonatal sensors is typically higher than measured by adult sensors, but the difference is not fixed and is less at the threshold indicative of cerebral hypoxia. Assuming fixed differences between adult and neonatal sensors may lead to overdiagnosis of cerebral hypoxia.

Impact

  • In comparison to adult sensors, neonatal sensors rScO2 readings are consistently higher, but the magnitude of the difference varies depending on the absolute value of rScO2.

  • Marked variability during high and low rScO2 readings was noted, with approximately 10% difference when adult sensors read 85%, but nearly similar (58.8%) readings when adult sensors read 55%.

  • Estimating fixed differences of approximately 10% between adult and neonatal probes may lead to an inaccurate diagnosis of cerebral hypoxia and result in subsequent unnecessary interventions.

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Fig. 1: Sample NIRS tracings.
Fig. 2: Comparison of the neonatal and adult sensors.
Fig. 3: Neonatal sensor readings at certain fixed values of the adult sensor.
Fig. 4: Comparing the two sensors under various patient conditions.

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Data availability

Datasets generated and analyzed during the current study are available from corresponding author on reasonable request.

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Funding

Funding

The study did not receive financial assistance.

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil

    Gabriel F. T. Variane, Julianna S. Kaneko & Marcella S. Gouveia

  2. Protecting Brains and Saving Futures Organization, São Paulo, Brazil

    Gabriel F. T. Variane & Julianna S. Kaneko

  3. Quantitative Sciences Unit, Stanford University School of Medicine, Palo Alto, CA, USA

    Alex Dahlen & Jingying Zeng

  4. Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children’s Hospital Stanford, Palo Alto, CA, USA

    Caroline Y. Noh, Elisabeth S. Yan, Krisa P. Van Meurs & Valerie Y. Chock

Authors
  1. Gabriel F. T. Variane
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Contributions

G.F.T.V. made substantial contributions to the study conception and design, interpretation of data, drafting the article and revising it critically for intellectual content, and final approval of version to be approved. A.D. and J.Z. made substantial contributions to the study conception and design, interpretation of data, drafting the article, and final approval of version to be approved. C.Y.N. made substantial contributions to the study conception and design, acquisition of data, interpretation of data, drafting the article and revising it critically for intellectual content, and final approval of version to be approved. E.S.Y., J.K., and M.G. made substantial contributions to the acquisition of data. K.P.V.M. and V.Y.C. made substantial contributions to the study conception and design, analysis and interpretation of data, drafting the article and revising it critically for intellectual content, and final approval of version to be approved.

Corresponding author

Correspondence to Gabriel F. T. Variane.

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Variane, G.F.T., Dahlen, A., Noh, C.Y. et al. Cerebral oxygen saturation in neonates: a bedside comparison between neonatal and adult NIRS sensors. Pediatr Res 94, 1810–1816 (2023). https://doi.org/10.1038/s41390-023-02705-z

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