title: Early oxygen-utilization and brain activity in preterm infants.
abstract: The combined monitoring of oxygen supply and delivery using Near-InfraRed spectroscopy (NIRS) and cerebral activity using amplitude-integrated EEG (aEEG) could yield new insights into brain metabolism and detect potentially vulnerable conditions soon after birth. The relationship between NIRS and quantitative aEEG/EEG parameters has not yet been investigated. Our aim was to study the association between oxygen utilization during the first 6 h after birth and simultaneously continuously monitored brain activity measured by aEEG/EEG. Forty-four hemodynamically stable babies with a GA < 28 weeks, with good quality NIRS and aEEG/EEG data available and who did not receive morphine were included in the study. aEEG and NIRS monitoring started at NICU admission. The relation between regional cerebral oxygen saturation (rScO2) and cerebral fractional tissue oxygen extraction (cFTOE), and quantitative measurements of brain activity such as number of spontaneous activity transients (SAT) per minute (SAT rate), the interval in seconds (i.e. time) between SATs (ISI) and the minimum amplitude of the EEG in μV (min aEEG) were evaluated. rScO2 was negatively associated with SAT rate (β=-3.45 [CI=-5.76- -1.15], p=0.004) and positively associated with ISI (β=1.45 [CI=0.44-2.45], p=0.006). cFTOE was positively associated with SAT rate (β=0.034 [CI=0.009-0.059], p=0.008) and negatively associated with ISI (β=-0.015 [CI=-0.026- -0.004], p=0.007). Oxygen delivery and utilization, as indicated by rScO2 and cFTOE, are directly related to functional brain activity, expressed by SAT rate and ISI during the first hours after birth, showing an increase in oxygen extraction in preterm infants with increased early electro-cerebral activity. NIRS monitored oxygenation may be a useful biomarker of brain vulnerability in high-risk infants.
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Dept. of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Tataranno
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Thomas
authors.initials: T
authors.lastname: Alderliesten
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Mona C
authors.initials: MC
authors.lastname: Toet
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Petra M A
authors.initials: PM
authors.lastname: Lemmers
authors.affiliation: Dept. of Medical Technology and Clinical Physics, University Services, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Renè E
authors.initials: RE
authors.lastname: Vosse van de
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: van Bel
authors.affiliation: Dept. of Perinatology and Brain Center Rudolph Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Centre for the Developing Brain, King's College London, London, United Kingdom.
authors.forename: Manon J N L
authors.initials: MJ
authors.lastname: Benders
mesh_terms: D001921:Brain / Q000378:metabolism* / Q000502:physiology; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D008297:Male; D010101:Oxygen Consumption; D019265:Spectroscopy, Near-Infrared