AUTHOR=Ćaleta Tomislav , Ryll Martin J. , Bojanić Katarina , Dessardo Nada Sindičić , Schroeder Darrell R. , Sprung Juraj , Weingarten Toby N. , Radoš Milan , Kostović Ivica , Grizelj Ruža 

TITLE=Regional cerebral oxygen saturation variability and brain injury in preterm infants

JOURNAL=Frontiers in Pediatrics

VOLUME=12

YEAR=2024

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2024.1426874

DOI=10.3389/fped.2024.1426874

ISSN=2296-2360

ABSTRACT=<sec><title>Objective</title><p>To examine whether variation of regional cerebral oxygen saturation (rScO<sub>2</sub>) within three days after delivery predicts development of brain injury (intraventricular/cerebellar hemorrhage or white matter injury) in preterm infants.</p></sec><sec><title>Study design</title><p>A prospective study of neonates &lt;32 weeks gestational age with normal cranial ultrasound admitted between 2018 and 2022. All received rScO<sub>2</sub> monitoring with near-infrared spectroscopy at admission up to 72 h of life. To assess brain injury a magnetic resonance imaging was performed at term-equivalent age. We assessed the association between rScO<sub>2</sub> variability (short-term average real variability, rScO<sub>2ARV</sub>, and standard deviation, rScO<sub>2SD</sub>), mean rScO<sub>2</sub> (rScO<sub>2MEAN</sub>), and percentage of time rScO<sub>2</sub> spent below 60% (rScO<sub>2TIME&lt;60%</sub>) during the first 72 h of life and brain injury.</p></sec><sec><title>Results</title><p>The median [IQR] time from birth to brain imaging was 68 [59-79] days. Of 81 neonates, 49 had some form of brain injury. Compared to neonates without injury, in those with injury rScO<sub>2ARV</sub> was higher during the first 24 h (<italic>P </italic>= 0.026); rScO<sub>2SD</sub> was higher at 24 and 72 h (<italic>P </italic>= 0.029 and <italic>P </italic>= 0.030, respectively), rScO<sub>2MEAN</sub> was lower at 48 h (<italic>P </italic>= 0.042), and rScO<sub>2TIME&lt;60%</sub> was longer at 24, 48, and 72 h (<italic>P </italic>= 0.050, <italic>P </italic>= 0.041, and <italic>P </italic>= 0.009, respectively). Similar results were observed in multivariable logistic regression. Although not all results were statistically significant, increased rScO<sub>2</sub> variability (rScO<sub>2ARV</sub> and rScO<sub>2SD</sub>) and lower mean values of rScO2 were associated with increased likelihood of brain injury.</p></sec><sec><title>Conclusions</title><p>In preterm infants increased aberration of rScO<sub>2</sub> in early postdelivery period was associated with an increased likelihood of brain injury diagnosis at term-equivalent age.</p></sec>