Anup C Katheria1, M J Harbert2, Sunil B Nagaraj3, Kathy Arnell2, Debra M Poeltler2, Melissa K Brown2, Wade Rich2, Kasim O Hassen2, Neil Finer2. 1. Department of Pediatrics, Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA. Electronic address: anup.katheria@sharp.com. 2. Department of Pediatrics, Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA. 3. Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Abstract
OBJECTIVE: To determine whether monitoring cerebral oxygen tissue saturation (StO2) with near-infrared spectroscopy (NIRS) and brain activity with amplitude-integrated electroencephalography (aEEG) can predict infants at risk for intraventricular hemorrhage (IVH) and death in the first 72 hours of life. STUDY DESIGN: A NIRS sensor and electroencephalography leads were placed on 127 newborns <32 weeks of gestational age at birth. Ten minutes of continuous NIRS and aEEG along with heart rate, peripheral arterial oxygen saturation, fraction of inspired oxygen, and mean airway pressure measurements were obtained in the delivery room. Once the infant was transferred to the neonatal intensive care unit, NIRS, aEEG, and vital signs were recorded until 72 hours of life. An ultrasound scan of the head was performed within the first 12 hours of life and again at 72 hours of life. RESULTS: Thirteen of the infants developed any IVH or died; of these, 4 developed severe IVH (grade 3-4) within 72 hours. There were no differences in either cerebral StO2 or aEEG in the infants with low-grade IVH. Infants who developed severe IVH or death had significantly lower cerebral StO2 from 8 to 10 minutes of life. CONCLUSIONS: aEEG was not predictive of IVH or death in the delivery room or in the neonatal intensive care unit. It may be possible to use NIRS in the delivery room to predict severe IVH and early death. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02605733.
OBJECTIVE: To determine whether monitoring cerebral oxygen tissue saturation (StO2) with near-infrared spectroscopy (NIRS) and brain activity with amplitude-integrated electroencephalography (aEEG) can predict infants at risk for intraventricular hemorrhage (IVH) and death in the first 72 hours of life. STUDY DESIGN: A NIRS sensor and electroencephalography leads were placed on 127 newborns <32 weeks of gestational age at birth. Ten minutes of continuous NIRS and aEEG along with heart rate, peripheral arterial oxygen saturation, fraction of inspired oxygen, and mean airway pressure measurements were obtained in the delivery room. Once the infant was transferred to the neonatal intensive care unit, NIRS, aEEG, and vital signs were recorded until 72 hours of life. An ultrasound scan of the head was performed within the first 12 hours of life and again at 72 hours of life. RESULTS: Thirteen of the infants developed any IVH or died; of these, 4 developed severe IVH (grade 3-4) within 72 hours. There were no differences in either cerebral StO2 or aEEG in the infants with low-grade IVH. Infants who developed severe IVH or death had significantly lower cerebral StO2 from 8 to 10 minutes of life. CONCLUSIONS:aEEG was not predictive of IVH or death in the delivery room or in the neonatal intensive care unit. It may be possible to use NIRS in the delivery room to predict severe IVH and early death. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02605733.
Authors: Anup C Katheria; Jeff M Szychowski; Jochen Essers; Marc R Mendler; Eugene M Dempsey; Georg M Schmölzer; Kathy Arnell; Wade D Rich; Kasim Hassen; Phillip Allman; Michael Varner; Gary R Cutter; Neil Finer Journal: J Pediatr Date: 2020-05-29 Impact factor: 4.406
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Authors: Angelika L Schwab; Benjamin Mayer; Dirk Bassler; Helmut D Hummler; Hans W Fuchs; Manuel B Bryant Journal: Front Pediatr Date: 2022-04-12 Impact factor: 3.418