Regional cerebral oxygen saturation variability and brain injury in preterm infants

Scientific paper - Original scientific paper

• Author: Tomislav Ćaleta
• Author: Martin J. Ryll
• Author: Katarina Bojanić
• Author: Nada Sindičić Dessardo
• Author: Darrell R. Schroeder
• Author: Juraj Sprung
• Author: Toby N. Weingarten
• Author: Milan Radoš
• Author: Ivica Kostović
• Author: Ruža Grizelj
• Author's institution: University of Zagreb; School of Medicine; (Croatian Institiute for Brain Research)
• Author's institution: University of Zagreb; School of Medicine; (Department of Pediatrics)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract (english)

Objective: To examine whether variation of regional cerebral oxygen saturation (rScO2) within three days after delivery predicts development of brain injury (intraventricular/cerebellar hemorrhage or white matter injury) in preterm infants.

Study design: A prospective study of neonates <32 weeks gestational age with normal cranial ultrasound admitted between 2018 and 2022. All received rScO2 monitoring with near-infrared spectroscopy at admission up to 72 h of life. To assess brain injury a magnetic resonance imaging was performed at term-equivalent age. We assessed the association between rScO2 variability (short-term average real variability, rScO2ARV, and standard deviation, rScO2SD), mean rScO2 (rScO2MEAN), and percentage of time rScO2 spent below 60% (rScO2TIME<60%) during the first 72 h of life and brain injury.

Results: The median [IQR] time from birth to brain imaging was 68 [59-79] days. Of 81 neonates, 49 had some form of brain injury. Compared to neonates without injury, in those with injury rScO2ARV was higher during the first 24 h (P = 0.026); rScO2SD was higher at 24 and 72 h (P = 0.029 and P = 0.030, respectively), rScO2MEAN was lower at 48 h (P = 0.042), and rScO2TIME<60% was longer at 24, 48, and 72 h (P = 0.050, P = 0.041, and P = 0.009, respectively). Similar results were observed in multivariable logistic regression. Although not all results were statistically significant, increased rScO2 variability (rScO2ARV and rScO2SD) and lower mean values of rScO2 were associated with increased likelihood of brain injury.

Conclusions: In preterm infants increased aberration of rScO2 in early postdelivery period was associated with an increased likelihood of brain injury diagnosis at term-equivalent age.

• Keywords (english): intraventricular hemorrhage; magnetic resonance imaging; near-infrared spectroscopy; neonates; preterm infants; regional cerebral oxygen saturation; white matter injury
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Frontiers in Pediatrics
• Numbering: vol. 12, 1426874
• e-ISSN: 2296-2360
• DOI: https://doi.org/10.3389/fped.2024.1426874
• URN:NBN: urn:nbn:hr:105:027791
• Publication: 2024-07-22
• Document URL: https://www.frontiersin.org/articles/10.3389/fped.2024.1426874/full
• Type of resource: Text
• Access conditions: Open access
• Created on: 2025-04-01 07:33:31