Effect of the "InSurE" procedure on cerebral oxygenation and electrical brain activity of the preterm infant

Archives of Disease in Childhood. Fetal and Neonatal Edition
E van den BergFrank van Bel


In preterm infants with respiratory distress syndrome (RDS) nasal continuous positive airway pressure (nCPAP) with the "InSurE" procedure (intubation, surfactant, extubation) is increasingly used. However, its effect on cerebral oxygenation and brain function is not known. To evaluate the effects of the "InSurE" procedure in infants with RDS on regional cerebral oxygen saturation (rScO(2)) and relative cerebral fractional tissue oxygen extraction (cFTOE) using near infrared spectroscopy and on electrical brain activity using amplitude-integrated electroencephalography (aEEG). Sixteen infants with RDS, treated with the "InSurE" procedure, and 16 matched controls with nCPAP, were monitored for mean arterial blood pressure (MABP), arterial oxygen saturation (SaO(2)), rScO(2), cFTOE and aEEG. Ten-minute periods were selected and averaged at 120 and 20 minutes before, during the procedure and at 30 minutes, 1, 2, 6, 12 and 24 h after the start of the "InSurE" procedure. aEEG was analysed by quantitative and qualitative (Burdjalov score) methods. MABP was not different between groups on all time points. rScO(2) and cFTOE were comparable between groups, but there was a trend towards lower rScO(2) and higher cFTOE 30 minutes after opio...Continue Reading


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