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Table of Contents
Vol. 94, No. 4, 2008
Issue release date: November 2008
Section title: Review
Neonatology 2008;94:237–244
(DOI:10.1159/000151642)

Monitoring Neonatal Regional Cerebral Oxygen Saturation in Clinical Practice: Value and Pitfalls

van Bel F.a · Lemmers P.a · Naulaers G.b
aPerinatal Center, Department of Neonatology, University Medical Center/Wilhelmina Children’s Hospital, Utrecht, The Netherlands; bDepartment of Pediatrics, University Hospital ‘Gasthuisberg’, Leuven, Belgium

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Article / Publication Details

First-Page Preview
Abstract of Review

Published online: September 10, 2008
Issue release date: November 2008

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

This review focuses on the clinical use of near infrared spectroscopy (NIRS) to assess brain oxygenation by the tissue oxygenation index (TOI), and monitoring regional cerebral oxygen saturation (rScO2), cerebral fractional tissue oxygen extraction (cFTOE), which is derived from rScO2, and systemic oxygen saturation. Its precision and pitfalls are discussed. At this stage, it is clear that NIRS-monitored oxygenation of the brain by rScO2 or TOI lacks the precision required to be used as a robust quantitative variable to monitor cerebral oxygenation. Intra- and especially interpatient variability are too large for this aim. On the other hand, when used merely as a trend monitor in the individual patient, substantial changes in rScO2 or TOI and consequently of cFTOE, larger than the limits of agreement, can yield important clinical information that suggest an intervention. Since neonatal intensive care is for a substantial part ‘brain orientated’ this approach seems conceivable. This gives rise to the conclusion that NIRS-monitored TOI, rScO2 and cFTOE increasingly will have a role in clinical practice as semiquantitative indicators of changes in cerebral oxygenation and oxygen extraction. Combination with other (cerebral) parameters such as amplitude-integrated EEG and blood pressure seems promising for further optimization of monitoring the immature brain.

© 2008 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Review

Published online: September 10, 2008
Issue release date: November 2008

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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