Abstract
Objective Neonates with sepsis have increased risk of cerebral injury. Our aim was to evaluate
cerebral oxygenation in septic neonates using near-infrared spectroscopy.
Study Design A prospective study was designed enrolling neonates with sepsis, as defined by the
International Consensus Conference of Pediatric Sepsis criteria and matched controls.
Three cerebral half–hourly measurements were performed during the first, third, and
seventh day of the episode and the values of tissue oxygenation index (TOI) and fractional
tissue oxygen extraction (FTOE) were compared between the two groups.
Result The study population consisted of 50 septic and 44 control neonates with similar
characteristics. No differences on TOI and FTOE were recorded in the first and third
day. However, on the seventh day, septic neonates had significantly decreased oxygenation
(62.7 ± 7 vs. 71.4 ± 4.4%, p < 0.001) and increased oxygen extraction (0.35 ± 0.07 vs. 0.27 ± 0.05, p < 0.001), irrespectively of the severity of the infection.
Conclusion Although septic neonates have normal cerebral oxygenation in the first and third
day of the sepsis, they present decreased cerebral oxygenation in the seventh day
independently of the infection severity.
Keywords
near-infrared spectroscopy - neonate - cerebral oxygenation - sepsis
