Cerebral hemodynamics during arousals in preterm infants.

The aim of the study was to evaluate potential changes of cerebral blood volume (CBV) related to arousals in preterm infants. As arousals are known to change different physiological parameters, it was postulated that this could also hold true for CBV. Polygraphic recordings were performed in 38 preterm infants (18 female, 20 male). The infants' gestational age at birth was 32.0+/-2.3 weeks, postconceptional age was 35.1+/-1.2 weeks and postnatal age at study entry was 24.3+/-2.9 days, birth weight was 1793+/-527 g and actual weight at study entry was 2011+/-324 g [mean (+/- standard deviation)]. CBV was measured using near infrared spectroscopy. Arousals were scored due to the guidelines of the "International Paediatric Work Group on Arousals" and categorized as either cortical (CA) or subcortical arousals (SCA). Altogether, 122 arousals (66 CA, 56 SCA) were scored. According to sleep stage, 77 arousals were analyzed in active sleep, 23 in quiet sleep and 22 in intermediate sleep. Mean duration of arousals was 8.8+/-0.3 s. CBV, cerebral vascular oxygenation and the balance between oxygen delivery and oxygen consumption remained constant during arousals in preterm infants. This was demonstrated for both CA and SCA and was independent of sleep stage, suggesting that the impact of arousals in stable preterm infants is too small to alter cerebral vascular autoregulation.