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Review
. 2017 Mar 14:5:46.
doi: 10.3389/fped.2017.00046. eCollection 2017.

Monitoring Cerebral Oxygenation in Neonates: An Update

Laura Marie Louise Dix  1 , Frank van Bel  2 , Petra Maria Anna Lemmers  2
Affiliations
Review

Monitoring Cerebral Oxygenation in Neonates: An Update

Laura Marie Louise Dix et al. Front Pediatr. .

Erratum in

Abstract

Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit.

Keywords: cerebral oxygenation; near-infrared spectroscopy; neonatal intensive care; neonatal neurology; neonates.

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Figures

Figure 1
Figure 1
(A) Regional cerebral oxygen saturation (rScO2) monitored with an adult (blue line) and pediatric (green line) sensor. Hyperoxia values are untraceable with the pediatric sensor due to the cutoff value of 95%. (B) Reference values [stratified for gestational age (GA)] of rScO2 in premature infants (GA < 32 weeks). Adapted from Ref. (29).
Figure 2
Figure 2
(A) Regional cerebral oxygen saturation (rScO2) just before ductal closure in patients treated with indomethacin (red squares) or surgery (blue circles) as a function of postnatal age in days. Note that the majority of infants requiring surgical treatment are exposed to the lowest rScO2 values for a longer period. Adapted from Ref. (14). (B) Acute end-tidal CO2 (etCO2) decrease results in a subsequent reduction in rScO2, on the contrary arterial oxygen saturation (SaO2) remains stable. MABP, mean arterial blood pressure. (C) rScO2 during hypothermia and after rewarming (rew) in two severely asphyxiated infants. The infant with an adverse outcome (blue line) showed higher rScO2 values compared to the infant that survived (green line). Cerebral fractional tissue oxygen extraction values (not shown) mirrored rScO2 values.
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