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Research Article Open Access
Objectives: The aims of this study include the following: to determine the effect of therapeutic hypothermia (Cooling) on cerebral saturations using Near Infrared Spectroscopy (NIRS) before, during and after therapeutic hypothermia; to compare these values between infants receiving sedative and anti-epileptic medications and those who do not.
Methods: This study is a retrospective chart review of patients from Children’s National Medical Center (CNMC) Neonatal Intensive Care Unit (NICU) who underwent therapeutic hypothermia with NIRS monitoring from July 2009- December 2014. Cerebral tissue saturations (StO2) using NIRS tissue oximeter (FORE-SIGHT, CAS Medical Systems, Branford, CT, USA) were assessed during the cooling period. StO2 were periodically recorded during 3 phases: before cooling was started, during cooling, and after cooling (30 minutes of rewarming) and averaged to a composite value for each event. Data was then compared based on whether the patient received sedatives and/or anti-epileptic medications.
Results: Complete data sets were obtained for 57 subjects, weighting 1.8 kg-4.9 kg, 1-7 days old and gestational age 35.6-42.0 weeks. Cerebral tissue saturations were significantly higher during cooling (paired t-test). Those on Phenobarbital and/or Versed had significantly higher saturations compared to those on no medications. Those on only Phenobarbital also had significantly higher saturations, but to a lesser degree. Subjects where StO2 failed to rise during cooling had a higher chance of dying, perhaps due to critical brain tissue damage from lack of oxygen during birth asphyxia, or failure to recover thereafter.
Conclusions: Data from this study suggests that cerebral tissue saturations increase during therapeutic hypothermia, likely due to suppressed cerebral metabolism. Those on anti-seizures medications
Near-infrared spectroscopy, Cerebral oxygenation, Birth Complications, Breastfeeding, Bronchopulmonary Dysplasia, Feeding Disorders, Gestational diabetes, Neonatal Anemia, Neonatal Breastfeeding, Neonatal Care, Neonatal Disease, Neonatal Drugs, Neonatal Health, Neonatal Infections, Neonatal Intensive Care, Neonatal Seizure, Neonatal Sepsis, Newborn Jaundice, Newborns Screening, Premature Infants, Sepsis in Neonatal, Vaccines and Immunity for Newborns