Prognostic Role of Cerebral Spectroscopy in Hypoxic-Ischemic Encephalopathy

Abstract

Background. Cerebral infrared spectroscopy reflects regional tissue oxygen saturation, representing the dynamic balance between oxygen delivery and consumption by brain tissue. Aim: determine the informative significance of cerebral spectroscopy in the diagnosis and assessment of the severity of hypoxic-ischemic encephalopathy (HIE) in newborns, and survival prognosis. Material and methods. The study included 90 full-term newborns with hypoxic-ischemic encephalopathy who suffered perinatal asphyxia. The subjects were divided into 3 groups depending on the severity of HIE (according to the classification of Sarnat H. and Sarnat M.): Group 1 - Severity grade 1, Group 2 - Severity grade 2, Group 3 - Severity grade 3. The control group consisted of 30 full-term newborns born without perinatal pathology. Near-Infrared Reflectance Spectroscopy (NIRS) was performed using a cerebral oximeter in the early neonatal period upon admission of the newborn to the hospital. Results. Significant differences in the index of fractional tissue oxygen extraction (FTOE) were found in newborns with hypoxic-ischemic encephalopathy compared with the control group (p<0.001). FTOE also differed significantly depending on the severity of HIE: at the 1st stage. was 0.204±0.061% [95% CI [0.160; 0.248]], at the 2nd and 3rd stages. - 0.145±0.067% [95% CI [0.122; 0.168]] and 0.103±0.066% [95% CI [0.083; 0.122]] (p<0.05). FTOE values were significantly higher in survivors - 0.143 compared to those who subsequently died - 0.054 (p<0.001). Conclusions. According to the results obtained, NIRS technology with FTOE determination can be successfully used in early diagnosis and grading of the severity of HIE, as well as survival prediction.