Department of Pediatrics, Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA.
Department of Pediatrics, Neonatal Research Institute at Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA.
J Pediatr. 2018 Jul;198:209-213.e3. doi: 10.1016/j.jpeds.2018.02.065. Epub 2018 Apr 18.
To determine whether monitoring cerebral oxygen tissue saturation (StO) with near-infrared spectroscopy (NIRS) and brain activity with amplitude-integrated electroencephalography (aEEG) can predict infants at risk for intraventricular hemorrhage (IVH) and death in the first 72 hours of life.
A NIRS sensor and electroencephalography leads were placed on 127 newborns <32 weeks of gestational age at birth. Ten minutes of continuous NIRS and aEEG along with heart rate, peripheral arterial oxygen saturation, fraction of inspired oxygen, and mean airway pressure measurements were obtained in the delivery room. Once the infant was transferred to the neonatal intensive care unit, NIRS, aEEG, and vital signs were recorded until 72 hours of life. An ultrasound scan of the head was performed within the first 12 hours of life and again at 72 hours of life.
Thirteen of the infants developed any IVH or died; of these, 4 developed severe IVH (grade 3-4) within 72 hours. There were no differences in either cerebral StO or aEEG in the infants with low-grade IVH. Infants who developed severe IVH or death had significantly lower cerebral StO from 8 to 10 minutes of life.
aEEG was not predictive of IVH or death in the delivery room or in the neonatal intensive care unit. It may be possible to use NIRS in the delivery room to predict severe IVH and early death.
ClinicalTrials.gov: NCT02605733.
确定近红外光谱（NIRS）监测脑氧组织饱和度（StO）和振幅整合脑电图（aEEG）监测脑活动是否能预测出生后 72 小时内有发生脑室出血（IVH）和死亡风险的婴儿。
对 127 名出生时胎龄<32 周的新生儿放置 NIRS 传感器和脑电图导联。在产房内获得 10 分钟的连续 NIRS 和 aEEG 以及心率、外周动脉血氧饱和度、吸入氧分数和平均气道压测量值。一旦婴儿被转移到新生儿重症监护病房，将记录 NIRS、aEEG 和生命体征，直到出生后 72 小时。出生后 12 小时内和 72 小时内行头颅超声检查。
13 名婴儿发生任何 IVH 或死亡；其中 4 名在 72 小时内发生严重 IVH（3-4 级）。低级别 IVH 婴儿的脑 StO 或 aEEG 无差异。发生严重 IVH 或死亡的婴儿从出生后 8 至 10 分钟开始脑 StO 显著降低。
aEEG 不能预测产房或新生儿重症监护病房的 IVH 或死亡。在产房使用 NIRS 可能有助于预测严重 IVH 和早期死亡。
ClinicalTrials.gov：NCT02605733。
