Is low cerebral near infrared spectroscopy oximetry associated with neurodevelopment of preterm infants without brain injury?

Stefano Tombolini; Flavia De Angelis; Alessio Correani; Paolo Marchionni; Chiara Monachesi; Enrica Ferretti; Francesca Staffolani; Rita D’Ascenzo; Virgilio Carnielli

doi:10.1515/jpm-2021-0498

Article

Is low cerebral near infrared spectroscopy oximetry associated with neurodevelopment of preterm infants without brain injury?

Stefano Tombolini , Flavia De Angelis , Alessio Correani , Paolo Marchionni , Chiara Monachesi , Enrica Ferretti , Francesca Staffolani , Rita D’Ascenzo and Virgilio Carnielli

Published/Copyright: March 22, 2022

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From the journal Journal of Perinatal Medicine Volume 50 Issue 5

Abstract

Objectives

To evaluate the association between low regional cerebral oxygen saturation (rScO2) and neurodevelopment in preterm infants classified as no brain injury (NBI).

Methods

We retrospectively reviewed data of rScO2 monitoring during the first 3 days of life of infants with a gestational age (GA)<28 weeks or birth weight (BW)<1,000 g, with and without brain injury (BI). BI was defined as intraventricular haemorrhage, cystic periventricular leukomalacia or cerebellar haemorrhage. Univariate and multivariate analyses were used to study the association of rScO2<55% for more than 10 h in the first 3 days of life (NIRS<55%^>10H) and the 24 months neurodevelopment.

Results

Of the 185 patients who met the inclusion criteria, 31% were classified as BI infants and 69% NBI. BI compared to NBI infants had a significantly lower GA and a higher incidence of complications of prematurity. Mean rScO2 in the first 72 h of life was significantly lower in BI than NBI. NIRS<55%^>10H in NBI patients was negatively associated with neurodevelopmental scores both at the univariate and multivariate analysis (p<0.05). NBI infants with NIRS<55%^>10H were found to have lower systemic oxygenation than their counterparts with rScO2<55% for less than 10 h.

Conclusions

NIRS<55%^>10H in NBI small preterm infants was found to be an independent predictor of neurodevelopment at 24 months and it was associated with low systemic saturation values.

Keywords: brain injury; near infrared spectroscopy (NIRS); neurodevelopment; preterm infants

Corresponding author: Alessio Correani, MSc, PhD, Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche, Ancona, Italy; and Division of Neonatology, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I - G. M. Lancisi - G. Salesi, Ancona, Italy, E-mail: a.correani@pm.univpm.it, Phone: +39 071 596 2888.

Acknowledgments

The authors are grateful to the NICU staff for the support provided.

Research funding: No financial support.
Author contribution: ST and FDA drafted the paper; EF, FS and RDA made the neurodevelopment assessment; AC, PM and CM contributed to the data analysis; VC conceptualized and designed the study. All authors read and approved the final manuscript.
Competing interests: The authors declare no conflicts of interest.
Informed consent: Not applicable.
Ethical approval: The study was approved by the review board and the local ethical committee (ID 2020179).

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Received: 2021-09-28

Accepted: 2022-02-21

Published Online: 2022-03-22

Published in Print: 2022-06-27

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Articles in the same Issue

https://doi.org/10.1515/jpm-2021-0498

Keywords for this article

brain injury; near infrared spectroscopy (NIRS); neurodevelopment; preterm infants