THE EFFECT OF BEHAVIORAL STATES ON CEREBRAL OXYGENATION DURING ENDOTRACHEAL SUCTIONING OF PRETERM BABIES

Near infrared spectroscopy (NIRS) was used to investigate the effect o f behavioural states on changes of oxygenated (O(2)Hb), deoxygenated h aemoglobin (HHb) and total haemoglobin (tHb), during endotracheal suct ioning. In an open prospective design, NIRS measurements have been don e during 20 suctioning episodes in 13 preterm neonates. Heart rate, ar terial oxygen saturation, and carbon dioxide tension were monitored co ntinuously, Behavioural state (BS) observations were made and document ed as well. The statistical analysis showed that in patients who were active, with crying periods during suctioning (behavioural states 4-5) , changes of oxygenated (p < 0.005) and deoxygenated haemoglobin (p < 0.05), as well as of arterial oxygen saturation (p < 0.05) and heart r ate (p < 0.05) were significantly greater than in patients who were qu iet with predominant behavioural state 1, 2 and 3, These results under line the influence of behavioural states on the physiological answers to endotracheal suctioning. MIRS proved to be a valuable tool to evalu ate possible harmful effects of different suctioning techniques.