O-161 Cerebral Oxygenation Before And After Neurosurgical Placement Of A Ventricular Reservoir In Neonates With Phvd

Abstract

Background There is no consensus regarding optimal timing in treating posthaemorrhagic ventricular dilatation (PHVD). Near-InfraRed Spectroscopy (NIRS) is a non invasive method, measuring cerebral regional oxygenation (rScO 2 ). rScO 2 values below 40–45% might be associated with cerebral ischaemia. Hypothesis: rScO 2 can provide additional information about cerebral oxygenation in infants with PHVD and may therefore be of value to determine timing of intervention. Methods We measured rcSO 2 in 13 neonates before and after neurosurgical placement of a ventricular reservoir. Based on ventricular index (VI; Levene), distinction was made in neonates treated early (VI Results Median GA 31 wks (27–37 wks) and median BW 1750 g (1145–3270 g). Five neonates were treated early and 8 late. In the early intervention group, pre-, and postoperative rScO2 values were comparable (median 52%, 45–58% IQR vs 57%, 44–60% IQR). Preoperative rScO 2 was lower in the late intervention group compared to postoperative values (median 33%, 26–43% IQR vs 47%, 39–49% IQR). In 7 late intervention infants rScO 2 was 2 remained Conclusions Neonates with VI≥97 + 4 mm do have a compromised cerebral oxygenation, and usually react to cerebrospinal fluid drainage with recovery of the rScO 2 values to within the normal range. Infants in the early intervention group were within normal range pre- and postoperatively. NIRS might be of additional clinical value in progressive PHVD in order to determine optimal timing for intervention.