Variations in regional cerebral blood volume in neonates associated with nursery care events.
This pilot study investigated the frequency of events that cause cerebral oxygenation disturbances in ventilator-dependant neonates in the neonatal intensive care unit. Continuous, noninvasive, near infrared spectrophotometry measurements (changes in oxy and deoxy hemoglobin concentration, and cytochrome C oxidase redox status) were made at half-second intervals on 10 ventilator-dependent neonates (30.5 weeks average corrected gestation age, 1051 g average weight) and annotated to nursery events at the bedside. Examples of disturbances affecting cerebral oxygenation were opening incubator doors, handling, heel stabs, conversation, blanket tucking, and steno-paging. These events produced 7-40% changes in blood volume for durations of 5-60 sec, and occurred at a rate of up to 45 events within a 2 hr period. Spectrometry detected 63% more events than were observed and documented clinically. Noninvasive monitoring of cerebral oxygenation status could give new insight into managing the high-risk infant environment.
Gagnon
R E
RE
Department of Paediatrics, Children's and Women's Health Centre of British Columbia, Vancouver, Canada.
Leung
A
A
Macnab
A J
AJ
D001955:British Columbia; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003580:Cytochromes / Q000097:blood*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000628:therapy; D015931:Intensive Care, Neonatal / Q000379:methods*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000097:blood*; D010865:Pilot Projects; D011379:Prognosis; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D013053:Spectrophotometry
D003580:Cytochromes; D006454:Hemoglobins; D010100:Oxygen