@article {van den BergF53, author = {E van den Berg and P M A Lemmers and M C Toet and J H G Klaessens and F van Bel}, title = {Effect of the {\textquotedblleft}InSurE{\textquotedblright} procedure on cerebral oxygenation and electrical brain activity of the preterm infant}, volume = {95}, number = {1}, pages = {F53--F58}, year = {2010}, doi = {10.1136/adc.2008.156414}, publisher = {BMJ Publishing Group}, abstract = {Background: In preterm infants with respiratory distress syndrome (RDS) nasal continuous positive airway pressure (nCPAP) with the {\textquotedblleft}InSurE{\textquotedblright} procedure (intubation, surfactant, extubation) is increasingly used. However, its effect on cerebral oxygenation and brain function is not known.Objective: To evaluate the effects of the {\textquotedblleft}InSurE{\textquotedblright} procedure in infants with RDS on regional cerebral oxygen saturation (rScO2) and relative cerebral fractional tissue oxygen extraction (cFTOE) using near infrared spectroscopy and on electrical brain activity using amplitude-integrated electroencephalography (aEEG).Methods: Sixteen infants with RDS, treated with the {\textquotedblleft}InSurE{\textquotedblright} procedure, and 16 matched controls with nCPAP, were monitored for mean arterial blood pressure (MABP), arterial oxygen saturation (SaO2), rScO2, cFTOE and aEEG. Ten-minute periods were selected and averaged at 120 and 20 minutes before, during the procedure and at 30 minutes, 1, 2, 6, 12 and 24 h after the start of the {\textquotedblleft}InSurE{\textquotedblright} procedure. aEEG was analysed by quantitative and qualitative (Burdjalov score) methods.Results: MABP was not different between groups on all time points. rScO2 and cFTOE were comparable between groups, but there was a trend towards lower rScO2 and higher cFTOE 30 minutes after opioid administration in the {\textquotedblleft}InSurE{\textquotedblright} infants compared with controls (62\% (SD 11) vs 68\% (SD 10) and 0.30 (SD 0.10 ) vs 0.28 (SD 0.11), respectively). aEEG amplitudes and Burdjalov scores were significantly lower in {\textquotedblleft}InSurE{\textquotedblright} infants from 30 minutes after opioid administration up to 24 h after the start of the procedure (p\<0.05).Conclusion: In the present study, the {\textquotedblleft}InSurE{\textquotedblright} procedure did not induce perturbation of cerebral oxygen delivery and extraction, whereas electrical brain activity decreased for a prolonged period of time.}, issn = {1359-2998}, URL = {https://fn.bmj.com/content/95/1/F53}, eprint = {https://fn.bmj.com/content/95/1/F53.full.pdf}, journal = {Archives of Disease in Childhood - Fetal and Neonatal Edition} }