Cerebral oxygenation during neonatal intubation: an observational study

Summary It is common for babies to become unstable with low blood oxygen levels during placement of a breathing tube (intubation) in neonates, which might harm the brain. This is an observational study of cerebral oxygenation and blood pressure during intubation in neonates.

Project Details

Babies who are born early (preterm) or very unwell may need intubation and a ventilator to help them breathe. Intubation may take some time or require repeated attempts. It is common for babies to become unstable with low blood oxygen levels during this process.

Standard monitoring during neonatal intubation includes pulse oximetry to measure oxygen saturation, heart rate monitoring and sometimes blood pressure. However, these provide only surrogate measures of blood flow to the brain in these babies. More recently, Near Infra Red Spectroscopy (NIRS) has been used in other settings to continuously monitor cerebral oxygen saturation and fractional tissue oxygen extraction. NIRS is a non-invasive technology whereby small sensors are applied to the skin to continuously monitor global cerebral oxygenation.

This study aims to measure cerebral oxygenation and blood pressure during neonatal intubation. We hope that this will give further information about the changes in oxygen delivery to the brain and blood pressure during placement of a breathing tube for babies.This study will be part of a larger study examining the use of nasal high flow (humidified air and oxygen delivered via two small nasal prongs) during neonatal intubation, which is currently underway. High flow has been proposed as a way of helping patients who are not breathing, during attempts to place a breathing tube. Cerebral oxygenation will be compared between the group receiving high flow and the group receiving no support during intubation.