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EEG maturation and stability of cerebral oxygen extraction in very low birth weight infants

Journal of Perinatology volume 36, pages 311–316 (2016)Cite this article

Subjects

Abstract

Objective:

Fractional cerebral tissue oxygen extraction (FTOE) can be continuously monitored by simultaneous near-infrared spectroscopy (NIRS) and pulse oximetry. The objective of this study is to test the hypothesis that in very low birth weight (VLBW) infants, the more mature EEG activity is, the less variable FTOE is.

Study Design:

A prospective study was conducted on VLBW infants (<1500 g and ⩽34 weeks gestation) without significant brain injury. Simultaneous continuous two-channel electroencephalography (EEG), NIRS and pulse oximetry were recorded. Absolute and relative powers of EEG in the delta, theta, alpha, beta and total frequency bands have been calculated. FTOE variability was calculated on two scales: short scales (3 to 20 s) and long scales (20 to 150 s). FTOE variability was examined against changes in relative spectral power of different EEG bands.

Result:

We evaluated 67 studies performed on 46 VLBW infants. Average study duration was 21.3±5.5 h. Relative power of delta band positively correlated with FTOE short- and long-scale variability (r=0.45, P<0.001; r=0.44, P<0.001, respectively). Relative power of alpha bands negatively correlated with FTOE short- and long-scale variability (r=−0.38, P=0.002; r=−0.42, P<0.001, respectively). These correlations continued to be significant when controlling for sex, small for gestational age, postmenstrual age, being on respiratory support, hemoglobin concentration, systemic oxygen saturation and transcutaneous carbon dioxide tension.

Conclusion:

Increased maturation of EEG activity is associated with decreased variability in cerebral oxygen extraction. The implications of increased variability in FTOE on brain injury in premature infants need further exploration.

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Acknowledgements

We acknowledge Dr Khalid Alyami, Dr Saleh Alqahtani and Dr Ahmad Ibrahim for their contribution in the data collection. This study was approved by the University Institutional Review Board (IRB). Informed consents were obtained from parents before enrollment.

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Authors and Affiliations

  1. Brigham and Women's Hospital, Boston, MA, USA

    M El-Dib

  2. Children's National Medical Center, Washington, DC, USA

    R Govindan, S Aly, M Mohamed, A du Plessis & H Aly

  3. The George Washington University, Washington, DC, USA

    S Aly, M Mohamed, A du Plessis & H Aly

Authors
  1. M El-Dib
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  2. R Govindan
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  3. S Aly
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  4. M Mohamed
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  5. A du Plessis
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  6. H Aly
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Correspondence to M El-Dib.

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El-Dib, M., Govindan, R., Aly, S. et al. EEG maturation and stability of cerebral oxygen extraction in very low birth weight infants. J Perinatol 36, 311–316 (2016). https://doi.org/10.1038/jp.2015.200

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  • DOI: https://doi.org/10.1038/jp.2015.200

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