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Cerebral oxygenation with different nasal continuous positive airway pressure levels in preterm infants
  1. Stefano Bembich,
  2. Laura Travan,
  3. Gabriele Cont,
  4. Jenny Bua,
  5. Tamara Strajn,
  6. Sergio Demarini
  1. Institute for Maternal and Child Health–IRCCS “Burlo Garofolo” – Trieste, Italy
  1. Correspondence to Dr Sergio Demarini, Division of Neonatology, Institute for Maternal and Child Health, IRCCS “Burlo Garofolo” Via dell'Istria, 65, Trieste I-34137, Italy; demarini{at}burlo.trieste.it

Abstract

Objectives This study evaluates the effect of varying nasal continuous positive airway pressure (NCPAP) level on cerebral blood flow (CBF) and oxygenation in preterm infants.

Methods Oxy-haemoglobin (HbO2) and total haemoglobin (HbTot), as CBF estimates, and the ratio between HbO2 and HbTot (HbO2/HbTot), as cerebral oxygenation estimate, were assessed by near-infrared spectroscopy in 26 stable preterm newborns at a postmenstrual age between 26 and 33 weeks. Baseline HbO2, HbTot and HbO2/HbTot values were initially collected with NCPAP at 5 cm H2O and then compared with values obtained with NCPAP levels at both 3 and 8 cm H2O.

Results Compared with 5 cm H2O, cerebral HbO2, HbTot and HbO2/HbTot remained unchanged both after increasing (to 8 cm H2O) and decreasing (to 3 cm H2O) the NCPAP level. This result was observed both in regional areas (24 sites) and in the overall monitored area (frontal and parietal cortex). Compared with 8 cm H2O, peripheral oxygen saturation significantly decreased at 3 cm H2O (p=0.021). Heart rate did not change.

Conclusions No differences in CBF and cerebral oxygenation were observed with NCPAP levels in the range 3–8 cm H2O despite a decrease in peripheral oxygenation with 3 cm H2O.

  • Neonatology
  • Respiratory

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