Cerebral Near-Infrared Spectroscopy and Electrical Cardiometry During Endotracheal Suction in Ventilated Infants Following Surgery: A Feasibility Study

Abstract

Background: Near-Infrared Spectroscopy (NIRS) and Electrical Cardiometry (EC) are promising non-invasive techniques for monitoring tissue oxygenation and hemodynamics, particularly in surgically ill infants who struggle to maintain cerebral oxygenation and systemic perfusion. There is limited data regarding the combined use of these techniques during respiratory procedures such as endotracheal suction in intubated infants.

Methods: The effects of 38 endotracheal suction maneuvers on cerebral oxygenation and cardiovascular hemodynamics were investigated in seven intubated infants following non-cardiac surgery. Parameters such as cerebral oxygenation and EC-derived metrics including heart rate, stroke volume, and cardiac output were assessed.

Results: Gestational and postnatal age were 31 weeks and 16 days. During endotracheal suction, the heart rate decreased but returned to baseline afterward. After the procedure, the cerebral oxygenation, stroke volume, and cardiac output increased.

Conclusions: Cerebral and systemic hemodynamics were altered during endotracheal suction maneuvers in ventilated infants. Combining NIRS and EC for monitoring cardiovascular and cerebrovascular physiology may enable more individualized therapy, helping to minimize cerebral injury in this vulnerable population.

Keywords: cerebral near-infrared-spectroscopy; electrical cardiometry; endotracheal suction; hemodynamics; neonatal surgery; non-invasive monitoring; respiratory procedures.

Figure 1

Correlations between the peripheral oxygen saturation (SpO₂), cerebral oxygenation (c-rSO₂), heart rate (HR), cardiac output (CO), and stroke volume (SV) during endotracheal suction. The red lines indicate correlation values of 1. The red lines indicate correlations coefficients of 1. *** is p ≤ 0.001.