scholarly journals The utility of cerebral oxygenation monitoring in premature neonates

2020 ◽  
Vol 89 (4) ◽  
pp. e485
Author(s):  
Saudamini Nesargi ◽  
Alexander Nitsch ◽  
Martin Wolf
Keyword(s):  
Infrared Spectroscopy ◽  
Preterm Infants ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Ductus Arteriosus ◽  
Neurological Outcomes ◽  
Standard Set ◽  
Oxygenation Monitoring ◽  
The Brain

Near-infrared spectroscopy allows the measurement of cerebral oxygenation in preterm infants. This study aimed to demonstrate several highly relevant clinical situations in preterm infants in which the standard set of monitoring parameters without near-infrared spectroscopy is not sufficient to detect possible adverse situations, possibly resulting in severe complications, i.e. adverse neurological outcomes. The examples include situations of low blood pressure, persistent open ductus arteriosus, malfunctioning autoregulation of the brain oxygenation, and periods of irregular breathing. Without near-infrared spectroscopy, it is impossible to determine whether such a situation imposes any risk for the brain, whereas the measurement of cerebral oxygenation as an additional source of information enables the clinician to recognise these conditions and modify treatment or use countermeasures to protect the patient from brain damage and ensuing lifelong disabilities.

Relationship Between Near-Infrared Spectroscopy-Derived Cerebral Oxygenation and Delirium in Critically Ill Patients: A Systematic Review

2018 ◽  
Vol 34 (6) ◽  
pp. 514-520 ◽  
Author(s):  
Nathaniel Bendahan ◽  
Oliver Neal ◽  
Amanda Ross-White ◽  
John Muscedere ◽  
J. Gordon Boyd
Keyword(s):  
Infrared Spectroscopy ◽  
Critically Ill ◽  
Near Infrared Spectroscopy ◽  
Critically Ill Patients ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Neurological Dysfunction ◽  
Neurological Outcomes ◽  
The Relationship

Background: A common neurological complication of critical illness is delirium, defined as an acute change in level of consciousness, with impaired attention and disorganized thinking. Patients with delirium have increased risk of long-term cognitive dysfunction and mortality. The cause is unknown, which limits our ability to design therapeutic interventions. In patients undergoing surgery, low regional cerebral oxygenation (rSO2), as measured by near-infrared spectroscopy (NIRS), is associated with postoperative neurological dysfunction (eg delirium and long-term cognitive impairment). However, the relationship between NIRS-derived rSO2 and neurological outcomes in critically ill patients is unclear. The objective of this study was to assess the utilization of NIRS-derived rSO2 in critically ill patients outside the operating theater. We aimed to examine the relationship between rSO2 and neurological outcomes as well as to report rSO2 values in this population. Methods: The following databases were searched from inception to August 14, 2017: Ovid MedLine, Embase, Cochrane Library, and Web of Science. Results: Of 1410 articles identified by the search strategy, 8 were ultimately selected for final review. Most (7 of 8) were published since 2014. These studies included a total of 213 patients primarily with shock or respiratory failure. A variety of devices were used to measure rSO2, including INVOS and FORESIGHT. The duration of recording varied from 5 minutes to 72 hours. Four of the 8 studies reported on neurological outcomes. In all 4 studies, rSO2 was lower in critically ill patients who were delirious compared to controls, but this was only statistically significant in 2 of the studies. The heterogeneity in devices and duration of recording precluded meta-analysis. Conclusions: There is limited literature describing rSO2 in critically ill patients outside the operating room. Although there may be a slight signal of an association between low rSO2 and delirium, more study is needed to explore this relationship.

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