Cerebral Oxygenation Monitoring

A Strategy to Detect Intraventricular Hemorrhage and Periventricular Leukomalacia

Heather E. Elser, MSN, RN, NNP-BC, CNS, PhD Student; Diane Holditch-Davis, PhD, RN, FAAN; Debra H. Brandon, PhD, RN, CCNS, FAAN


NAINR. 2011;11(3):153-159. 

In This Article


Premature infants' neurodevelopment is vulnerable to alterations compared with full-term infants because of an immature nervous system and early exposure to the neonatal intensive care environment.[79] Because premature infants are nonverbal, vital signs are one of the primary methods to examine the effects of underlying neurologic damage. Cerebral oximeters measure cerebral oxygenation in a noninvasive manner, based upon the Beer-Lambert law. A cerebral oximeter machine may show value at the bedside for the high-risk premature infant population in the NICU by providing real-time changes in cerebral oxygenation values that may, one day, be used as an instrument for neuroprotection in premature infants. Detection of altered cerebral oxygenation using cerebral oximetry may help to identify subtle, abnormal, neurologic activity before behavioral changes are manifested.

Currently, neonatal providers rely on nonspecific measurements to indicate adequate cerebral perfusion in premature infants. Cerebral oxygenation measurements would provide a more direct assessment of the percentage of oxygen in the brain and, in the future, have predictive ability to identify infants at risk for cerebral damage. However, before cerebral oxygenation can be accepted as a standard of care, normative values based on age and over the course of hospitalization are needed as well as complete understanding of its benefits over the current vital sign measures. As more knowledge is gained through research, the potential for cerebral oxygenation monitoring to reduce neurologic complications will be revealed to provide optimal care for premature infants.


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