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Updated: Jul 19, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Can tissue oxygenation index (TOI) and cotside neurophysiological variables predict outcome in depressed/asphyxiated
Patrizia Zaramella1, Elisabetta Saraceni, Federica Freato
1Department of Paediatrics, Neonatal Intensive Care Unit, University of Padova, Via Giustiniani, 3, 35128 Padova, Italy. zaramella@pediatria.unipd.it
Background:
Diagnostic tools of birth asphyxia provide only an uncertain prediction of neurological outcome.
Aims:
To assess whether TOI and DeltaCBV, combined with a set of biochemical and neurophysiological variables, have any diagnostic and prognostic value in birth depression or asphyxia.
Study Design:
Case control study at the nursery and NICU of the Padova University Children's Hospital.
Subjects:
22 term neonates with an Apgar score < or = 6 at 5', a 1-h umbilical artery pH value < or = 7.25 with an increased base deficit and a gestational age > or = 36 weeks; 15 healthy term infants with an Apgar score > or = 9 at 5'.
Outcome Measures:
Troponin I and NIRS measurements (TOI and DeltaCBV) were assessed in both groups. Blood gases, neurological evaluation, US, NIRS, EEG and SEP were evaluated in the infants with depression or asphyxia.
Results:
Troponin I was higher in the study group than in controls (p=0.04), showing a correlation with base excess values. In the depressed/asphyxiated neonates with an abnormal outcome at 1 year, TOI rose to 80.1% vs 66.4% in controls (p=0.04) and 74.7% in infants with a normal 1-year outcome. A multiple regression model showed a significant multiple correlation coefficient, R=0.79, p<0.001, where the predictive variables significantly associated with outcome were SEP and BE.
Conclusions:
Troponin I is a useful short-term index of birth asphyxia or perinatal depression. An increased TOI suggests a risk of abnormal neurological outcome at 1 year. Among the cotside variables, BE and evoked potential abnormalities were the best predictors of abnormal outcome in this study.
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