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Observational Study
. 2019 Jul 24;14(7):e0220044.
doi: 10.1371/journal.pone.0220044. eCollection 2019.

The prognostic value of NIRS in preterm infants with (suspected) late-onset sepsis in relation to long term outcome: A pilot study

Inge A Zonnenberg  1 , Jennifer van Dijk  2 , Frank A M van den Dungen  1 , R Jeroen Vermeulen  3 , Mirjam M van Weissenbruch  1
Affiliations
Observational Study

The prognostic value of NIRS in preterm infants with (suspected) late-onset sepsis in relation to long term outcome: A pilot study

Inge A Zonnenberg et al. PLoS One. .

Abstract

Late-onset sepsis is frequently seen in preterm infants and is associated with poor neurodevelopmental outcome. White matter damage is proposed as substrate of poor outcome, with contributing factors as regional hypoxia and effects of cytokines on oligodendrocytes. We investigated the relation between cerebral oxygenation during (suspected) late-onset sepsis and neurodevelopmental outcome. Prospective cohort study, including preterm infants (gestational age <32 weeks and/or birthweight <1500 grams) with (suspected) late-onset sepsis underwent NIRS registration during the first 72 hours of suspected late-onset sepsis. At two years corrected age neurodevelopment was scored using the Bayley Scales of Infant Development-II. Thirty-two infants were included. Twenty-seven infants were identified with proven late-onset sepsis and five infants had clinical sepsis without positive blood culture. In this study, late-onset sepsis was predominantly caused by coagulase negative staphylococci (CoNS) (72%). All NIRS values were within normal limits. No association was found between NIRS and impaired neurodevelopmental outcome (n = 4) at corrected age two years: composite cognitive score 105 (80-115), composite motor score 103 (82-118) (median and range). In this pilot study, late-onset sepsis (predominantly caused by CoNS with a relatively mild clinical course), was not associated with aberrant NIRS values, nor with impaired neurodevelopmental outcome. Further research might establish our findings and elucidate effects of other micro-organisms on cerebral perfusion.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Mean rScO2 and FTOE during first three days of late-onset sepsis.
rScO2: regional cerebral oxygenation saturation; cFTOE: cerebral fractional tissue oxygen extraction; h: hours.
Fig 2
Fig 2. Lowest rScO2 (8 hour interval) and composite cognitive and motor outcome based on the Bayleys Scales of Infant Development II.
rScO2: regional cerebral oxygenation saturation.
See this image and copyright information in PMC

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