AUTHOR=Zhou Han , Hou Xuewen , Cheng Rui , Zhao Youyan , Qiu Jie 

TITLE=Effects of Nasal Continuous Positive Airway Pressure on Cerebral Hemodynamics in Preterm Infants

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00487

DOI=10.3389/fped.2020.00487

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> To evaluate the effects of pressure levels on cerebral hemodynamics in premature infants receiving nasal continuous positive airway pressure (nCPAP) during the first 3 days of life.</p><p><bold>Methods:</bold> Forty-four preterm infants treated with nCPAP were divided into two groups: very preterm infants [gestational age 1 (GA1), GA &lt; 32 weeks, <italic>n</italic> = 24] and moderate/late preterm infants (GA2 group, GA 32–37 weeks, <italic>n</italic> = 20). During monitoring, pressure levels were set at 4 → 6 → 8 → 4 cmH<sub>2</sub>O, and cerebral hemodynamics was assessed by near-infrared spectroscopy (NIRS). Vital signs, peripheral oxygen saturation (SpO<sub>2</sub>) and transcutaneous carbon dioxide pressure (TcPCO<sub>2</sub>) were simultaneously recorded.</p><p><bold>Results:</bold> Pressures of 4–8 cmH<sub>2</sub>O had no significant influence on cerebral hemodynamics, TcPCO<sub>2</sub>, SpO<sub>2</sub> or other vital signs. The tissue oxygenation index (TOI), the difference between oxygenated hemoglobin (ΔHbO<sub>2</sub>) and deoxygenated hemoglobin (ΔHHb) (ΔHbD), and cerebral blood volume (ΔCBV) were all significantly positively correlated with gestational and post-natal age, with fluctuations being greater in the GA1 group. ΔHbD and ΔCBV were also significantly positively correlated with TcPCO<sub>2</sub>.</p><p><bold>Conclusions:</bold> No significant differences were observed in cerebral hemodynamics when the nCPAP pressure was set to 4–8 cmH<sub>2</sub>O.</p>