Cerebral and mesenteric tissue oxygenation by positional changes in very low birth weight premature infants

Aim: There has been no clear consensus of the appropriate positioning in preterm infants. We aimed to evaluate the changes of cerebral and mesenteric tissue oxygenation in three different positions, by near infrared spectroscopy (NIRS), in stable very low birth weight (VLBW) infants of postnatal > 30 days. Methods: NIRS monitoring of cerebral and mesenteric tissue oxygenation in three different positions was performed in 29 stable preterm newborns in neonatal intensive care unit (NICU). The patients were observed in three different positions consecutively, each lasting for 4 h. The demographic features, cerebral and mesenteric tissue oxygenation with positional changes and feeding periods were recorded. Results: Mean gestational age, mean birth weight and mean postnatal age of the patients were 27.6 +/- 1.7 weeks, 1046 +/- 308 g and 42.4 +/- 15.7 days, respectively. There were no statistically significant differences in cerebral and mesenteric tissue regional SO2 values in each position (p = 0.954 and p = 0.151, respectively). The values of cerebral and mesenteric tissue regional SO2 before and after feeding did not show any statistically significant difference in each position. Conclusions: Clinically stable very low birth weight infants are able to maintain a stable cerebral and mesenteric tissue oxygenation in different positions, both before and after feeding. Positional changes seem to be safe in VLBW stable infants and this influence should be considered in care of these patients in the NICU. Clinical Trials Identification Number: NCT01255189. (C) 2011 Elsevier Ireland Ltd. All rights reserved.