Brain haemodynamic effects of nasal continuous airway pressure in preterm infants of less than 30 weeks' gestation.
OBJECTIVE
To evaluate the hypothesis that increasing levels of nasal continuous positive airway pressure (NCPAP) may decrease cerebral blood volume (CBV) and cerebral oxygenation in infants with gestational age (GA) less than 30 weeks.


METHODS
We prospectively studied a cohort of preterm infants treated with NCPAP using near-infrared spectroscopy (NIRS). The pressure limit of NCPAP was set at 2, 4, 6 and again 2 cm H(2)O for 30 min.


RESULTS
Changes of pressure levels were not followed by significant changes of oxygenated haemoglobin (O(2)Hb), deoxygenated haemoglobin (HHb), cerebral intravascular oxygenation (HbD), oxidized-reduced cytochrome aa3 (CtOx), tissue oxygenation index (TOI), tissue haemoglobin index (THI) and cerebral blood volume (DeltaCBV).


CONCLUSIONS
NCPAP at 2-6 cm H(2)O pressure levels did not affect cerebral oxygenation and CBV. These findings are reassuring and confirm the safety of NCPAP in preterm infants with GA less than 30 weeks.
Dani
Carlo
C
Section of Neonatology, Department of Surgical and Medical Critical Care, Careggi University Hospital of Florence, Viale Morgagni 85, 50134 Florence, Italy. cdani@unifi.it
Bertini
Giovanna
G
Cecchi
Alessandra
A
Corsini
Iuri
I
Pratesi
Simone
S
Rubaltelli
Firmino F
FF
D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D045422:Continuous Positive Airway Pressure; D005260:Female; D005865:Gestational Age; D006305:Health Status Indicators; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared
D006454:Hemoglobins