Research Article
Volume 10 Issue 12 - 2021
Regional Cerebral Oxygenation Variability Before, During and After Routine Clinical Practices in Preterm Newborns in Intensive Care
Rodríguez Susana1*, Cardetti Marcelo2, Celiz Maiara2, Menzio Mónica3, Muñoz Cristian3, Arguello Jonathan4, Arguello Ana Clara4, Vives Ivana5, García Palacin Constanza5, Riveros Oscar5, Palma Agustín5 and Sola Augusto6
11Scientific Director Iberoamerican Society of Neonatology (SIBEN), Director of Research and Education, Hospital Juan P Garrahan, Buenos Aires, Argentina
22Neonatology Department, Clinic and Maternity Center for Endocrinology and Human Reproduction, San Luis, Argentina. Iberoamerican Society of Neonatology (SIBEN)
33Neonatology Department, Teresita Baigorria Hospital, San Luis Argentina. Iberoamerican Society of Neonatology (SIBEN)
34Neonatology Department, Clinic and Maternity Center for Endocrinology and Human Reproduction, San Luis, Argentina
3Neonatology Department, Teresita Baigorria Hospital, San Luis Argentina
3Director Iberoamerican Society of Neonatology (SIBEN) USA
*Corresponding Author: Rodriguez Susana, Scientific Director Iberoamerican Society of Neonatology (SIBEN), Director of Research and Education, Hospital Juan P Garrahan, Buenos Aires, Argentina.
Received: November 08, 2021; Published: November 26, 2021




Abstract

Introduction: Preterm newborns receive a large number of interventions during NICU stay; some are potentially damaging to the developing brain. Their possible deleterious effects on regional cerebral oxygen saturation (rScO2) have not been well-defined.

Objective: To describe feasibility of routine noninvasive rScO2 monitorization in NICU and assess effects of different NICU practices on rScO2 in preterm infants.

Method: Proof of concept, descriptive study on 25-36 weeks’ gestation infants in NICU. During the first 5 days, we assessed rSCO2 for 5 minutes before a clinically necessary intervention (PRE), during (INTRA), and 5 minutes after (POST), without modifications of care protocols. Monitor used was O3® Regional oximetry (Masimo Corp, Irvine, Ca). Statistics: ANOVA for repeated rSCO2 measures; post-hoc analyses using paired t tests with Bonferroni adjustment. Significance was set at < 0.05.

Results: There were 384 interventions analyzed in 37 preterm newborns with gestational age 31 ± 3.3 weeks and birth weight 1450 ± 667 grams. Seventy percent (269) of the rSCO2 measurements were in infants receiving oxygen therapy. During the procedure INTRA rSCO2 decreased by 2.21%, 95% CI of -1.67 to - 2.75 (p < 0,001). rSCO2 changes were widely variable (extreme values between - 22% to + 14%). The worst rSCO2 decreases occurred in the more immature infants with lower birth weight (p < 0,001). POST rSCO2 values were statistically not different to PRE rSCO2 but 46% did not show full recovery of their rSCO2.

Conclusion: Most of the interventions in ill preterm infants induced rSCO2 changes, with wide variability. Therefore, continuous rSCO2 monitoring could be valuable to avoid regional cerebral hypoxia or hyperoxia in an individualized manner in order to improve patient safety.

Keywords: Neonate; Interventions; Clinical Care; Regional Cerebral Oxygen Saturation

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