aEEG and NIRS during transition and resuscitation after birth: promising additional tools; an observational study

During resuscitation no routine cerebral monitoring is available. We aimed at monitoring cerebral activity and oxygenation continuously during neonatal transition and resuscitation.

Neonates ≥34 weeks of gestation born via cesarean section were included. Cerebral activity was continuously measured with amplitude-integrated-EEG (aEEG) and cerebral oxygenation (rSO2) with near-infrared-spectroscopy (NIRS) during the first 10 min after birth. For quantitative analysis of aEEG every minute the mean minimum amplitude (V(min)) and maximum amplitude (V(max)) was determined. Uncompromised neonates were compared to neonates in need of resuscitation.

Out of 224 eligible neonates 31 uncompromised and 15 in need of respiratory support were included. Uncompromised neonates showed higher values for V(min) in the third minute and higher values for V(max) in the third and fourth minute compared to the tenth minute post-partum. In uncompromised neonates rSO2 values during the first 6 min after birth were lower compared to minute ten. Neonates in need of respiratory support had lower rSO2 values over the first 8 min after birth compared to minute ten.

This is the first study demonstrating that monitoring of aEEG and NIRS to measure cerebral activity and oxygenation during immediate postpartum transition is feasible. During transition compromised neonates requiring resuscitation showed a different cerebral activity pattern compared to uncompromised neonates.