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.