Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study
Purpose: This study aimed to describe cerebral Near InfraRed Spectroscopy (NIRS) profiles during neonatal intubation using two different premedication regimens.Methods: Neonates requiring non-emergency intubation were enrolled in an ancillary study, conducted in two French Neonatal Intensive Care Un...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2019-03-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2019.00040/full |
| _version_ | 1811253896342929408 |
|---|---|
| author | Meryl Vedrenne-Cloquet Meryl Vedrenne-Cloquet Sophie Breinig Agnes Dechartres Camille Jung Sylvain Renolleau Laetitia Marchand-Martin Xavier Durrmeyer Xavier Durrmeyer |
| author_facet | Meryl Vedrenne-Cloquet Meryl Vedrenne-Cloquet Sophie Breinig Agnes Dechartres Camille Jung Sylvain Renolleau Laetitia Marchand-Martin Xavier Durrmeyer Xavier Durrmeyer |
| author_sort | Meryl Vedrenne-Cloquet |
| collection | DOAJ |
| description | Purpose: This study aimed to describe cerebral Near InfraRed Spectroscopy (NIRS) profiles during neonatal intubation using two different premedication regimens.Methods: Neonates requiring non-emergency intubation were enrolled in an ancillary study, conducted in two French Neonatal Intensive Care Units participating in a larger on-going multicenter, double blind, randomized, controlled trial. Patients were randomly assigned to the “atropine-propofol” (Prop) group or the “atropine-atracurium-sufentanil” (SufTrac) group. Regional cerebral oxygen saturation (rScO2), pulse oxymetry (SpO2), mean arterial blood pressure (MABP), and transcutaneous partial pressure of carbon dioxide (TcPCO2) were collected at 9 predefined time points from 1 min before to 60 min after the first drug injection. The two primary outcomes were a decrease in rScO2 value >20% from baseline and a decrease in fractional cerebral tissue oxygen extraction (FTOE) value >10% from baseline, at any time point. Secondary outcomes included physiological parameters changes over time and correlations between mean arterial blood pressure, and FTOE at different time points. Descriptive results were obtained and exploratory statistical analyses were performed for 24 included patients.Results: rScO2 decreased in 5/11 (46%) infants from the Prop group and 10/13 (77%) from the SufTrac group (p = 0.11); FTOE decreased in 10/11 (91%) infants from the Prop group, and 12/13 (92%) from the SufTrac group (p = 0.90). rScO2 values decreased over time in both groups, whereas FTOE's pattern appeared more stable. SpO2 and transcutaneous TcPCO2 seemed more preserved in the Prop group while MABP seemed more preserved in the SufTrac group. No important correlation was observed between MABP and FTOE (r = 0.08 to 0.12 across the time points).Conclusion: Our results suggest a frequent decrease in cerebral oxygenation without obvious impairment in cerebral autoregulation during neonatal intubation with premedication. This study confirms the feasibility and the informative value of cerebral NIRS monitoring in this setting.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02700893. |
| first_indexed | 2024-04-12T16:58:47Z |
| format | Article |
| id | doaj.art-be34922da8864d0cbffa082a8b48c426 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-12T16:58:47Z |
| publishDate | 2019-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-be34922da8864d0cbffa082a8b48c4262022-12-22T03:24:08ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602019-03-01710.3389/fped.2019.00040436674Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–StudyMeryl Vedrenne-Cloquet0Meryl Vedrenne-Cloquet1Sophie Breinig2Agnes Dechartres3Camille Jung4Sylvain Renolleau5Laetitia Marchand-Martin6Xavier Durrmeyer7Xavier Durrmeyer8Neonatal Intensive Care Unit, CHI Créteil, Créteil, FrancePediatric Intensive Care Unit, Necker University Hospital, Paris, FranceNeonatal and Pediatric Intensive Care Unit, Toulouse University Hospital, Toulouse, FranceInserm U1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Département Biostatistique santé publique, information médicale–Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Sorbonne Université, Paris, FranceClinical Research Center, CHI Créteil, Créteil, FrancePediatric Intensive Care Unit, Necker University Hospital, Paris, FranceINSERM, UMR1153, Obstetrical, Perinatal and Paediatric Epidemiology (Epopé) Team, Epidemiology and Biostatistics Sorbonne, Paris Descartes University, Paris, FranceNeonatal Intensive Care Unit, CHI Créteil, Créteil, FranceFaculté de Médecine de Créteil, IMRB, GRC CARMAS, Université Paris Est Créteil, Créteil, FrancePurpose: This study aimed to describe cerebral Near InfraRed Spectroscopy (NIRS) profiles during neonatal intubation using two different premedication regimens.Methods: Neonates requiring non-emergency intubation were enrolled in an ancillary study, conducted in two French Neonatal Intensive Care Units participating in a larger on-going multicenter, double blind, randomized, controlled trial. Patients were randomly assigned to the “atropine-propofol” (Prop) group or the “atropine-atracurium-sufentanil” (SufTrac) group. Regional cerebral oxygen saturation (rScO2), pulse oxymetry (SpO2), mean arterial blood pressure (MABP), and transcutaneous partial pressure of carbon dioxide (TcPCO2) were collected at 9 predefined time points from 1 min before to 60 min after the first drug injection. The two primary outcomes were a decrease in rScO2 value >20% from baseline and a decrease in fractional cerebral tissue oxygen extraction (FTOE) value >10% from baseline, at any time point. Secondary outcomes included physiological parameters changes over time and correlations between mean arterial blood pressure, and FTOE at different time points. Descriptive results were obtained and exploratory statistical analyses were performed for 24 included patients.Results: rScO2 decreased in 5/11 (46%) infants from the Prop group and 10/13 (77%) from the SufTrac group (p = 0.11); FTOE decreased in 10/11 (91%) infants from the Prop group, and 12/13 (92%) from the SufTrac group (p = 0.90). rScO2 values decreased over time in both groups, whereas FTOE's pattern appeared more stable. SpO2 and transcutaneous TcPCO2 seemed more preserved in the Prop group while MABP seemed more preserved in the SufTrac group. No important correlation was observed between MABP and FTOE (r = 0.08 to 0.12 across the time points).Conclusion: Our results suggest a frequent decrease in cerebral oxygenation without obvious impairment in cerebral autoregulation during neonatal intubation with premedication. This study confirms the feasibility and the informative value of cerebral NIRS monitoring in this setting.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT02700893.https://www.frontiersin.org/article/10.3389/fped.2019.00040/fullneonatal intubationpremedicationcerebral oxygenationnear infrared spectroscopyhypotensionpropofol |
| spellingShingle | Meryl Vedrenne-Cloquet Meryl Vedrenne-Cloquet Sophie Breinig Agnes Dechartres Camille Jung Sylvain Renolleau Laetitia Marchand-Martin Xavier Durrmeyer Xavier Durrmeyer Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study Frontiers in Pediatrics neonatal intubation premedication cerebral oxygenation near infrared spectroscopy hypotension propofol |
| title | Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study |
| title_full | Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study |
| title_fullStr | Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study |
| title_full_unstemmed | Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study |
| title_short | Cerebral Oxygenation During Neonatal Intubation–Ancillary Study of the Prettineo–Study |
| title_sort | cerebral oxygenation during neonatal intubation ancillary study of the prettineo study |
| topic | neonatal intubation premedication cerebral oxygenation near infrared spectroscopy hypotension propofol |
| url | https://www.frontiersin.org/article/10.3389/fped.2019.00040/full |
| work_keys_str_mv | AT merylvedrennecloquet cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT merylvedrennecloquet cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT sophiebreinig cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT agnesdechartres cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT camillejung cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT sylvainrenolleau cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT laetitiamarchandmartin cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT xavierdurrmeyer cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy AT xavierdurrmeyer cerebraloxygenationduringneonatalintubationancillarystudyoftheprettineostudy |