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Since some important forms of brain injury in premature infants are caused in considerable part by disturbances in cerebral blood flow (CBF), it is important to be able to detect whether the cerebrovascular autoregulation, the mechanism by which CBF is maintained constant despite alterations in mean arterial blood pressure (MAP), is working properly. A recent study suggested that concordant changes in MAP and cerebral intravascular oxygenation (HbD), measured non-invasively by near-infrared spectroscopy (NIRS) as the difference between the concentration changes of oxygenated hemoglobin (HbO2) and deoxygenated hemoglobin (Hb), reflect impaired cerebrovascular autoregulation. Consequently, premature infants with impaired cerebrovascular autoregulation could be identified by simultaneous, continuous measurements of HbD and MAP. From several premature babies, MAP, HbD and arterial oxygen saturation (SaO2) were measured simultaneously at the University Hospital Leuven, Belgium. The concordance between MAP and HbD was quantitated using three different measures, among which a newly developed measure that looks for similarity of the dynamics between signals. Some preliminary results obtained from the measured data are given.

No normal values of tissue oxygenation index (TOI) of the brain are known regarding premature born infants. We measured TOI, a measure for the cerebral hemoglobin oxygen saturation, on the head of 15 preterm infants with a median postmenstrual age of 28 weeks (interquartile range (IQR) between 26-29 weeks) with spatially resolved spectroscopy (NIRO 300, Hamamatsu) during the first three days of life. Infants with intra-ventricular hemorrhage or periventricular leucomalacia before the first measurement, as shown by ultrasound, were excluded. The first measurement was done within the first 6 hours of life, the second and third measurement at, respectively, 24 and 48 hours after this first measurement. The mean TOI was calculated if saturation did not change by more than 5% for at least 30 minutes. Other parameters measured were PaO2, PCO2, pH, mean arterial blood pressure, heart rate, hemoglobin, glycemia and peripheral oxygen saturation. There was a significant increase of TOI after 24 (p0.05) and 48 (p0.001) hours. The median TOI on the first day was 57% (95% CI: 54-65.7), 66.1% on the second day (95%CI: 61.9-82.3%) and 76.1% on the third day (95%CI 67.8-80.1%). No correlation was found between TOI and peripheral oxygen saturation, blood pressure, PaO2, PaCO2 and hemoglobin concentration after multiple regression analysis. TOI increases in the first three days in premature born babies. The increase of TOI is not due to an increase of oxygenation or mean arterial blood pressure. In our opinion, it reflects the increase in cerebral blood flow during the first three days.