Head Position Change Is Not Associated with Acute Changes in Bilateral Cerebral Oxygenation in Stable Preterm Infants during the First 3 Days of Life

Abstract

Objective Several recent intraventricular hemorrhage prevention bundles include midline head positioning to prevent potential disturbances in cerebral hemodynamics. We aimed to study the impact of head position change on regional cerebral saturations (SctO₂) in preterm infants (< 30 weeks gestational age) during the first 3 days of life.

Study Design Bilateral SctO₂ was measured by near-infrared spectroscopy. The infant's head was turned sequentially to each side from midline (baseline) in 30-minute intervals while keeping the body supine. Bilateral SctO₂ before and after each position change were compared using paired t-test.

Results In relatively stable preterm infants (gestational age 26.5 ± 1.7 weeks, birth weight 930 ± 220 g; n = 20), bilateral SctO₂ remained within normal range (71.1–75.3%) when the head was turned from midline position to either side.

Conclusion Stable preterm infants tolerated brief changes in head position from midline without significant alternation in bilateral SctO₂; the impact on critically ill infants needs further evaluation.

Keywords

near-infrared spectroscopy - cerebral autoregulation - cerebral oxygenation - head positioning - premature infants

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