AEEG and NIRS during transition and resuscitation after birth: Promising additional tools; an observational study

Abstract

Aim of the studyDuring resuscitation no routine cerebral monitoring is available. We aimed at monitoring cerebral activity and oxygenation continuously during neonatal transition and resuscitation. MethodsNeonates ≥34 weeks of gestation born via cesarean section were included. Cerebral activity was continuously measured with amplitude-integrated-EEG (aEEG) and cerebral oxygenation (rSO2) with near-infrared-spectroscopy (NIRS) during the first 10min after birth. For quantitative analysis of aEEG every minute the mean minimum amplitude (Vmin) and maximum amplitude (Vmax) was determined. Uncompromised neonates were compared to neonates in need of resuscitation. ResultsOut of 224 eligible neonates 31 uncompromised and 15 in need of respiratory support were included. Uncompromised neonates showed higher values for Vmin in the third minute and higher values for Vmax in the third and fourth minute compared to the tenth minute post-partum. In uncompromised neonates rSO2 values during the first 6min after birth were lower compared to minute ten. Neonates in need of respiratory support had lower rSO2 values over the first 8min after birth compared to minute ten. ConclusionsThis is the first study demonstrating that monitoring of aEEG and NIRS to measure cerebral activity and oxygenation during immediate postpartum transition is feasible. During transition compromised neonates requiring resuscitation showed a different cerebral activity pattern compared to uncompromised neonates.