Effects of nasal continuous positive airway pressure on cerebral hemodynamics in preterm infants

Abstract Background To evaluate effects of different positive end-expiratory pressure (PEEP) levels on cerebral hemodynamics of premature infants when using nasal continuous positive airway pressure (nCPAP) during the first 3 days of life. Methods Forty-four preterm infants treated with nCPAP were divided into very preterm infant group (gestational age 1 (GA1) group, GA<32 weeks, n=24) and moderate and late preterm group (GA2 group, GA 32-37 weeks, n=20). During the monitoring process, the PEEP was set at 4→6→8→4 cmH 2 O and cerebral hemodynamics was assessed by near-infrared spectroscopy (NIRS). Life signs, peripheral oxygen saturation (SpO 2 ) and transcutaneous carbon dioxide pressure (TcPCO 2 ) were recorded at the same time. Results Tissue oxygenation index (TOI), cerebral blood volume (△CBV) and the difference between oxygenated hemoglobin (△HbO 2 ) and deoxygenated hemoglobin (△HHb) (△HbD) were all significantly positive correlated with gestational and postnatal age and the fluctuation of GA1 group was greater. △CBV and △HbD were also significantly positive correlated with TcPCO 2 . PEEP of 4-8 cmH 2 O had no significant influence on cerebral hemodynamics, life signs, SpO 2 or TcPCO 2 . Conclusions No significant differences were observed in cerebral hemodynamics when the PEEP was set from 4 to 8 cmH 2 O. These findings confirmed the safety and reliability of nCPAP at regular pressure levels to the nervous system of preterm infants.