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Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
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Does Cerebral Oxygenation Change during Peripherally Inserted Central Catheterization in Preterm Infants?

Gözde Ercan1, Ebru Y Imamoglu2, Özlem Şahin3

  • 1Department of Pediatrics, Faculty of Health Sciences, Sancaktepe Prof Ilhan Varank Training and Research Hospital, İstanbul, Turkey.

American Journal of Perinatology
|January 20, 2023
PubMed
Summary

Monitoring cerebral oxygenation with near-infrared spectroscopy (NIRS) during peripherally inserted central venous catheterization (PICC) in preterm infants is valuable. A significant decrease in cerebral oxygen saturation was observed post-PICC, highlighting the need for neuroprotective strategies.

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Area of Science:

  • Neonatal intensive care
  • Pediatric cardiology
  • Medical device technology

Background:

  • Peripherally inserted central venous catheters (PICCs) are essential for very low birth weight preterm infants.
  • Cerebral oxygenation monitoring is crucial for neuroprotection in this vulnerable population.

Purpose of the Study:

  • To evaluate the impact of PICC placement on cerebral oxygenation in very low birth weight preterm infants using near-infrared spectroscopy (NIRS).
  • To identify potential neuroprotective strategies by assessing cerebral oxygen saturation (rSO2) changes during and after PICC procedures.

Main Methods:

  • Prospective study involving 41 preterm infants (gestational age ≤32 weeks, birth weight ≤1,500g) undergoing PICC.
  • Cerebral regional oxygen saturation (rSO2) measured by NIRS recorded at baseline and every 5 minutes for 30 minutes post-catheterization.
  • Hemodynamic parameters and cerebral fractional oxygen extraction were also monitored.

Main Results:

  • A significant decrease in cerebral rSO2 was observed in 46% of infants at 15 minutes post-PICC and 22% at 30 minutes.
  • No significant changes in heart rate, mean arterial blood pressure, or cerebral fractional oxygen extraction were noted.
  • The median time for cerebral rSO2 to return to baseline was 25 minutes.

Conclusions:

  • NIRS monitoring of cerebral rSO2 during PICC procedures is clinically useful in very low birth weight preterm infants.
  • Proactive assessment and management of factors affecting cerebral oxygenation before PICC insertion may serve as a neuroprotective strategy.
  • Early detection and intervention for decreased cerebral oxygenation can potentially improve neurodevelopmental outcomes.