Abstract
Background: Near-Infrared-Spectroscopy (NIRS) is a reliable noninvasive method and has been widely used in neonatology to measure acute changes of cerebral hemodynamics (i.e. during surfactant application - Edwards et al.). But clinical interpretation of NIRS data is still difficult. During long-time monitoring (2h) in healthy term newborns cyclical fluctuations of NIRS parameters were seen (Urlesberger et al.). In preterm and sick infants an impaired cerebral autoregulation can be found, that will most likely influence NIRS data (Boylan et al.). The aim of the study was to investigate, how NIRS parameters vary over time in preterm infants during quiet periods under NICU conditions.
Methods: In 5 ventilated preterms (26.–29.weeks) NIRS measurements with a Niro 200 monitor (Hamamatsu Photonics Germany) during 90 min (± 5) were performed. Time periods of 60 undisturbed minutes were evaluated. Changes of NIRS data (oxygenated and total Hb, Tissue Oxygenation Index, Tissue Haemoglobin Index) were calculated as a difference between the maximum and base line values. For subsequent analysis the monitoring period was divided into 5 minutes intervals.
Results: During quiet periods over 60 min a mean of 4.5 (± 0.9) spontaneous fluctuations per interval of 5 minutes were recorded. The mean amplitude of these simultaneous fluctuations was: oxyHb 2.07 (± 0.4)ìmol/l, total Hb 2.9 (± 0.6)ìmol/l, TOI 2.5% (± 0.2) und THI 4.5% (± 0.5). The vital parameters remained stable during the entire period.
Conclusion: We found NIRS easy to use in preterms, it did not affect the infants well being. Long periods of an undisturbed cerebral monitoring were obtained. During repeated measurements we could reproduce the NIRS data. We think it is necessary to record the individual spontaneous fluctuations under quiet conditions. So an intraindividual comparsion with NIRS measurments of acute changes is possibel and can help to evaluate and interpret this data. This could help to create a valuable cerebral longtime monitoring and to guide clinical decisions.
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Burkhardt, W., Rüdiger, M., Hammer, H. et al. 45 Near-Infrared-Spectroscopy: Spontaneous Fluctuations of Cerebral Oxygenation and Hemodynamics in Preterm Infants. Pediatr Res 56, 471 (2004). https://doi.org/10.1203/00006450-200409000-00068
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DOI: https://doi.org/10.1203/00006450-200409000-00068