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Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
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Effects of Prone Sleeping on Cerebral Oxygenation in Preterm Infants

Kelsee L Shepherd1, Stephanie R Yiallourou2, Alexsandria Odoi1

  • 1The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, Australia.

The Journal of Pediatrics
|October 10, 2018
PubMed

Insights

Prone sleeping may reduce cerebral blood flow in extremely preterm infants during the first week of life. This effect was not observed in very preterm infants until later. Further research is needed for unstable infants.

Area of Science:

  • Neonatal physiology
  • Neuroprotection
  • Preterm infant care

Background:

  • Cerebral oxygenation is critical for preterm infant development.
  • The prone sleeping position is common in neonatal intensive care units.
  • Understanding the impact of sleep position on cerebral hemodynamics is essential.

Purpose of the Study:

  • To investigate the effect of prone sleeping on cerebral oxygenation in preterm infants.
  • To compare these effects between extremely preterm and very preterm infants.
  • To assess the influence of sleep state and postnatal age.

Main Methods:

  • Weekly measurements of cerebral tissue oxygenation index (TOI) and arterial oxygen saturation (SaO2) in preterm infants.
  • Calculation of cerebral fractional tissue extraction (CFOE) to assess cerebral blood flow.
  • Comparison of prone and supine positions during active and quiet sleep.

Main Results:

  • Extremely preterm infants showed increased CFOE (reduced cerebral blood flow) in the prone position at 1 week of age.
  • Very preterm infants did not exhibit position-related CFOE differences until 5 weeks of age.
  • In very preterm infants, active sleep was associated with decreased TOI and increased CFOE.

Conclusions:

  • Prone sleeping may reduce cerebral blood flow in extremely preterm infants early in life.
  • These findings offer physiological insights into preterm infant sleep position effects.
  • Further studies are recommended for unstable preterm infants to assess potential risks of cerebral injury.
Abstract

Keywords:
NICUcerebral fractional oxygen extractioncerebral oxygenationpreterm infantsprone sleep position

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