Experimental Brain Research

, Volume 173, Issue 3, pp 458–467 | Cite as

Cerebral oxygenation and cerebral oxygen extraction in the preterm infant: the impact of respiratory distress syndrome

  • Petra M. A. Lemmers
  • Mona Toet
  • Leonard J. van Schelven
  • Frank van Bel
Research Article

Abstract

Haemodynamic factors play an important role in the etiology of cerebral lesions in preterm infants. Respiratory distress syndrome (RDS), a common problem in preterms, is strongly related with low and fluctuating arterial blood pressure. This study investigated the relation between mean arterial blood pressure (MABP), fractional cerebral oxygen saturation (ScO2) and fractional (cerebral) tissue oxygen extraction (FTOE), a measure of oxygen utilisation of the brain, during the first 72 h of life. Thirty-eight infants (gestational age < 32 week) were included, 18 with and 20 without RDS. Arterial oxygen saturation (SaO2), MABP and near infrared spectroscopy-determined ScO2 were continuously measured. FTOE was calculated as a ratio: (SaO2–ScO2)/SaO2. Gestational age and birth weight did not differ between groups, but assisted ventilation and use of inotropic drugs were more common in RDS infants (P<0.01). MABP was lower in RDS patients (P<0.05 from 12 up to 36 h after birth), but increased in both groups over time. ScO2 and FTOE were not different between groups over time, but in RDS infants ScO2 and FTOE had substantial larger variance (P<0.05 at all time points except at 36–48 h for ScO2 and P<0.05 at 12–18, 18–24, 36–48 and 48–60 h for FTOE). During the first 72 h of life, RDS infants showed more periods of positive correlation between MABP and ScO2 (P<0.05 at 18–24, 24–36 36–48 48–60 h) and negative correlation between MABP and FTOE (P<0.05 at 18–24, 36–48 h). Although we found that the patterns of cerebral oxygenation and extraction in RDS infants were not different as compared to infants without RDS, we suggest that the frequent periods with possible lack of cerebral autoregulation in RDS infants may make these infants more vulnerable to cerebral damage.

Keywords

Preterm infant Near infrared spectroscopy Cerebral oxygenation/extraction Respiratory distress syndrome 

Abbreviations

FTOE

Fractional (cerebral) tissue oxygen extraction

MABP

Mean arterial blood pressure

NIRS

Near infrared spectroscopy

RDS

Respiratory distress syndrome

PDA

Persistent ductus arteriosus

PIVH

Periventricular/intraventricular haemorrhage

SaO2

Arterial oxygen saturation

ScO2

Fractional cerebral oxygen saturation

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Petra M. A. Lemmers
    • 1
  • Mona Toet
    • 1
  • Leonard J. van Schelven
    • 2
  • Frank van Bel
    • 1
  1. 1.Department of NeonatologyUniversity Medical Centre, Wilhelmina Children’s HospitalAB UtrechtThe Netherlands
  2. 2.Department of Biomedical EngineeringUniversity Medical Centre, Wilhelmina Children’s HospitalUtrechtThe Netherlands

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