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  • Title: Near-infrared spectroscopy to detect absence of cerebrovascular autoregulation in preterm infants.
    Author: Verhagen EA, Hummel LA, Bos AF, Kooi EM.
    Journal: Clin Neurophysiol; 2014 Jan; 125(1):47-52. PubMed ID: 23973384.
    Abstract:
    OBJECTIVE: Our aim was to explore clinical parameters that might predict the absence of cerebrovascular autoregulation (CAR) assessed by a negative relationship between mean arterial blood pressure (MABP) and fractional tissue oxygen extraction (FTOE) as measured by near-infared spectroscopy (NIRS) in preterm infants. METHODS: We included preterm infants (gestational age (GA) <32 weeks). Within 72 h after birth, we recorded the infants' NIRS parameters and MABP for a 24-h period. Fractional tissue oxygen extraction (FTOE) was calculated. For each infant we calculated Spearman rank (rho) correlations. A statistically significant negative correlation between MABP and FTOE indicated the absent CAR. We related the absent CAR to clinical parameters. RESULTS: Ten (40%) out of 25 infants (median GA 29.1 weeks, range 25.4-31.7, birth weight 1245 g, 560-1780) had a statistically significant negative correlation between MABP and FTOE (rho -0.432 to -0.156), suggesting the absence of CAR. None of the clinical variables predicted the absence of CAR. CONCLUSIONS: We were unable to predict the absence of CAR in terms of clinical variables. Nevertheless, we found a statistically significant negative correlation between MABP and FTOE using NIRS, suggesting the absence of CAR in almost half of the preterm infants studied. SIGNIFICANCE: NIRS could be a helpful tool to assess the presence or absence of CAR.
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