Neuromonitoring of the preterm infant

Brain injury and its effect on long-term neurodevelopment will continue to be one of the main challenges in neonatal medicine in upcoming years. 

The etiology of brain injury is multifactorial. However, damage often occurs as a combination of hypoxic-ischemic insults, inflammatory procedures, and oxidative stress in an immature brain that is experiencing complex maturation events that make it highly vulnerable to these stressors. 

Neuromonitoring permits early detection of the impact on the brain of numerous insults that may happen in the intensive care setting, with the principal purpose of directing the management of these patients and, thus, raising the number of patients with normal neurodevelopmental outcomes. Additionally, neuromonitoring also explains the physiology of the transition to extrauterine life and understanding of the physiological changes related to the care delivered by the health care team in collaboration with families.

Along with neurologic examination and neuroimaging techniques, the two main approaches used for persistent neurologic monitoring are amplitude-integrated electroencephalography (aEEG) and monitoring of cerebral regional oxygen saturation (crSO2) by near-infrared spectroscopy (NIRS), known as cerebral oximetry.

Source: An Pediatr (Engl Ed). 2021 Dec;95(6):395-396. doi: 10.1016/j.anpede.2021.07.003. Epub 2021 Oct 9. PMID: 34635461.