TY - JOUR
T1 - Low Cerebral Oxygenation in Preterm Infants Is Associated with Adverse Neurodevelopmental Outcome
AU - Alderliesten, Thomas
AU - van Bel, Frank
AU - van der Aa, Niek E.
AU - Steendijk, Paul
AU - van Haastert, Ingrid C.
AU - de Vries, Linda S.
AU - Groenendaal, Floris
AU - Lemmers, Petra
N1 - Copyright © 2018 Elsevier Inc. All rights reserved.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Objective: To assess whether high and low levels of cerebral oxygenation (regional cerebral oxygenation [rScO
2 ]) in infants born at <32 weeks of gestation were associated with adverse long-term outcome. Study design: Observational cohort study including preterm infants born at <32 weeks of gestation at the Wilhelmina Children's Hospital, The Netherlands, between April 2006 and April 2013. The rScO
2 was continuously monitored for 72 hours after birth using near-infrared spectroscopy. Outcome was assessed at 15 and 24 months of corrected age by certified investigators. An unfavorable composite outcome was defined as an outcome score below -1 SD or death. Various rScO
2 thresholds were explored. Results: In total, 734 infants were eligible for analysis, 60 of whom died. Associations with an unfavorable cognitive outcome in multivariable analysis were comparable for time spent with a rScO
2 below 55% and -1.5 SD (according to published reference values), with an OR of 1.4 (CI 1.1-1.7) for 20% of time below either threshold. Results at 15 months were comparable with results at 24 months. Results were not statistically significant for thresholds defining high values of rScO
2 . The composite motor outcome was not significantly related to either low or high values or rScO
2 . Conclusions: Low, but not high, rScO
2 was associated with an unfavorable cognitive outcome. This suggests the use of a threshold of rScO
2 <55% for future clinical studies when using adult near-infrared sensors (rScO
2 <65% for neonatal sensors, approximately).
AB - Objective: To assess whether high and low levels of cerebral oxygenation (regional cerebral oxygenation [rScO
2 ]) in infants born at <32 weeks of gestation were associated with adverse long-term outcome. Study design: Observational cohort study including preterm infants born at <32 weeks of gestation at the Wilhelmina Children's Hospital, The Netherlands, between April 2006 and April 2013. The rScO
2 was continuously monitored for 72 hours after birth using near-infrared spectroscopy. Outcome was assessed at 15 and 24 months of corrected age by certified investigators. An unfavorable composite outcome was defined as an outcome score below -1 SD or death. Various rScO
2 thresholds were explored. Results: In total, 734 infants were eligible for analysis, 60 of whom died. Associations with an unfavorable cognitive outcome in multivariable analysis were comparable for time spent with a rScO
2 below 55% and -1.5 SD (according to published reference values), with an OR of 1.4 (CI 1.1-1.7) for 20% of time below either threshold. Results at 15 months were comparable with results at 24 months. Results were not statistically significant for thresholds defining high values of rScO
2 . The composite motor outcome was not significantly related to either low or high values or rScO
2 . Conclusions: Low, but not high, rScO
2 was associated with an unfavorable cognitive outcome. This suggests the use of a threshold of rScO
2 <55% for future clinical studies when using adult near-infrared sensors (rScO
2 <65% for neonatal sensors, approximately).
KW - hemodynamics
KW - Near-infrared spectroscopy
KW - neonatology
KW - neurology
UR - http://www.scopus.com/inward/record.url?scp=85058554797&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2018.11.038
DO - 10.1016/j.jpeds.2018.11.038
M3 - Article
C2 - 30577979
SN - 0022-3476
VL - 207
SP - 109-116.e2
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
ER -