Objective:

The aim of this study was to determine if changes in cerebral oxygenation are a reliable indicator of changes in cerebral oxygen delivery in an established preterm piglet model.

Background:

Preterm infants are at high risk of brain injury, poor cerebral perfusion and oxygenation contributes to this risk. Monitoring of cerebral oxygenation using near-infrared spectroscopy (NIRS) is not routine in infants as its utility has not been established in this population.

Design/Methods:

Cerebral tissue oxygenation index (TOI; NIRS), cerebral oxygen delivery (COD; carotid flow probe), invasive blood pressure, and fractional total oxygen extraction (FTOE) were measured in 23 preterm piglets (98/115d gestation: ~28 wk infant) at 5-11h after birth.

Results:

TOI and COD co-varied in 74% (17/23) of preterm piglets and those that lacked coherence had significantly lower blood pressure (14±8 vs 24±12mmHg; p=0.043), lower TOI (29±9 vs 54±21%; p<0.01), and higher FTOE (66±9 vs 41±21%; p<0.01) than piglets that did have coherence. Of those lacking coherence, 4/6 piglets were from the same litter.

Conclusions:

Cerebral oxygenation (NIRS) reliably detected changes in cerebral oxygen delivery in most preterm piglets. A lack of coherence was associated with poor cardiovascular function. Further studies in humans are warranted to determine if cerebral NIRS monitoring can detect cardiovascular deterioration in preterm infants and hence prevent brain injury in this vulnerable population.