Objective To assess the association of cerebral oxygen saturation (CrSO2) collected
by near infrared spectroscopy (NIRS) during therapeutic hypothermia (TH) and rewarming
with evidence of brain injury on post-rewarming MRI. Study design This retrospective
cohort study included 49 infants, who received TH for mild to severe neonatal encephalopathy.
Of those, 26 presented with brain injury assessed by a novel MRI grading system, whereas
23 had normal MRI scans. Results CrSO2 increased significantly from the first to the
second day of TH in infants with brain injury, whereas it remained stable in patients
with normal MRI. Increasing mean CrSO2 values during rewarming was associated with
brain injury (aOR 1.14; 95% CI 1.00-1.28), specifically with gray matter (GM) injury
(aOR 1.23; 95% CI 1.02-1.49). The area under the ROC curve showed an excellent discrimination
for GM involvement. Conclusion Clinically applied NIRS during TH and rewarming can
assist in identifying the risk for brain injury.
