Iranian Journal of Pediatrics

Published by: Kowsar

Cerebral Tissue Oxygenation in Postural Changes in Mechanically Ventilated Preterm Newborns Less than 72 Hours after Birth

Aida Ravarian 1 , Shahin Nariman 1 , Fariba Noori 1 , Farhoud Saeid Ershadi 2 , Amin Shahrokhi 3 , Mehdi Noroozi 4 and Roshanak Vameghi 3 , *
Authors Information
1 NICU Unit, Arash Women ‘s Hospital, Tehran University of Medical Sciences (TUMS), Tehran, IR Iran
2 Orthotics and Prosthetic department, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
3 Pediatric Neuro-rehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
4 Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
Article information
  • Iranian Journal of Pediatrics: October 2017, 27 (5); e12405
  • Published Online: October 20, 2017
  • Article Type: Research Article
  • Received: May 1, 2017
  • Revised: August 1, 2017
  • Accepted: August 14, 2017
  • DOI: 10.5812/ijp.12405

To Cite: Ravarian A, Nariman S, Noori F, Ershadi F S, Shahrokhi A, et al. Cerebral Tissue Oxygenation in Postural Changes in Mechanically Ventilated Preterm Newborns Less than 72 Hours after Birth, Iran J Pediatr. 2017 ; 27(5):e12405. doi: 10.5812/ijp.12405.

Copyright © 2017, Iranian Journal of Pediatrics. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Methods
4. Results
5. Discussion
  • 1. Waitzman KA. The Importance of Positioning the Near-term Infant for Sleep, Play, and Development. Newborn Infant Nurs Rev. 2007; 7(2): 76-81[DOI]
  • 2. Vergara E, Bigsby R. Developmental and therapeutic interventions in the NICU. 2004;
  • 3. Ramachandran S, Dutta S. Early developmental care interventions of preterm very low birth weight infants. Indian Pediatr. 2013; 50(8): 765-70[PubMed]
  • 4. Anderson J. Sensory intervention with the preterm infant in the neonatal intensive care unit. Am J Occup Ther. 1986; 40(1): 19-26[PubMed]
  • 5. Rivas-Fernandez M, Roque IM, Diez-Izquierdo A, Escribano J, Balaguer A. Infant position in neonates receiving mechanical ventilation. Cochrane Database Syst Rev. 2016; 11[DOI][PubMed]
  • 6. Visscher F, van der Graaf T, Spaans M, van Lingen RA, Fetter WP. [Prone position favors motor development of infants]. Ned Tijdschr Geneeskd. 1998; 142(40): 2201-5[PubMed]
  • 7. Mizuno K, Inoue M, Takeuchi T. The effects of body positioning on sucking behaviour in sick neonates. Eur J Pediatr. 2000; 159(11): 827-31[PubMed]
  • 8. Bhat RY, Hannam S, Pressler R, Rafferty GF, Peacock JL, Greenough A. Effect of prone and supine position on sleep, apneas, and arousal in preterm infants. Pediatrics. 2006; 118(1): 101-7[DOI][PubMed]
  • 9. Davis BE, Moon RY, Sachs HC, Ottolini MC. Effects of sleep position on infant motor development. Pediatrics. 1998; 102(5): 1135-40[PubMed]
  • 10. Ratliff-Schaub K, Hunt CE, Crowell D, Golub H, Smok-Pearsall S, Palmer P, et al. Relationship between infant sleep position and motor development in preterm infants. J Dev Behav Pediatr. 2001; 22(5): 293-9[PubMed]
  • 11. Wu J, Zhai J, Jiang H, Sun Y, Jin B, Zhang Y, et al. Effect of Change of Mechanical Ventilation Position on the Treatment of Neonatal Respiratory Failure. Cell Biochem Biophys. 2015; 72(3): 845-9[DOI][PubMed]
  • 12. Gouna G, Rakza T, Kuissi E, Pennaforte T, Mur S, Storme L. Positioning effects on lung function and breathing pattern in premature newborns. J Pediatr. 2013; 162(6): 1133-7[DOI][PubMed]
  • 13. Chang YJ, Anderson GC, Dowling D, Lin CH. Decreased activity and oxygen desaturation in prone ventilated preterm infants during the first postnatal week. Heart Lung. 2002; 31(1): 34-42[PubMed]
  • 14. Kishan J, Bhargava SK, Rehman F. Effect of posture on arterial oxygen tension in preterm infants. Indian Pediatr. 1981; 18(10): 701-4[PubMed]
  • 15. Askie LM. Optimal oxygen saturations in preterm infants: a moving target. Curr Opin Pediatr. 2013; 25(2): 188-92[DOI][PubMed]
  • 16. Schmid MB, Hopfner RJ, Lenhof S, Hummler HD, Fuchs H. Cerebral desaturations in preterm infants: a crossover trial on influence of oxygen saturation target range. Arch Dis Child Fetal Neonatal Ed. 2013; 98(5)-8[DOI][PubMed]
  • 17. Pellicer A, Gaya F, Madero R, Quero J, Cabanas F. Noninvasive continuous monitoring of the effects of head position on brain hemodynamics in ventilated infants. Pediatrics. 2002; 109(3): 434-40[PubMed]
  • 18. Fuchs G, Schwarz G, Kulier A, Litscher G. The influence of positioning on spectroscopic measurements of brain oxygenation. J Neurosurg Anesthesiol. 2000; 12(2): 75-80[PubMed]
  • 19. Kurihara K, Kikukawa A, Kobayashi A. Cerebral oxygenation monitor during head-up and -down tilt using near-infrared spatially resolved spectroscopy*. Clin Physiol Function Imag. 2003; 23(4): 177-81[DOI]
  • 20. Lovell AT, Marshall AC, Elwell CE, Smith M, Goldstone JC. Changes in cerebral blood volume with changes in position in awake and anesthetized subjects. Anesth Analg. 2000; 90(2): 372-6[PubMed]
  • 21. Liem KD, Greisen G. Monitoring of cerebral haemodynamics in newborn infants. Early Hum Dev. 2010; 86(3): 155-8[DOI][PubMed]
  • 22. Kissack CM, Garr R, Wardle SP, Weindling AM. Postnatal changes in cerebral oxygen extraction in the preterm infant are associated with intraventricular hemorrhage and hemorrhagic parenchymal infarction but not periventricular leukomalacia. Pediatr Res. 2004; 56(1): 111-6[DOI][PubMed]
  • 23. Baik N, Urlesberger B, Schwaberger B, Schmolzer GM, Avian A, Pichler G. Cerebral haemorrhage in preterm neonates: does cerebral regional oxygen saturation during the immediate transition matter? Arch Dis Child Fetal Neonatal Ed. 2015; 100(5)-7[DOI][PubMed]
  • 24. Ancora G, Maranella E, Aceti A, Pierantoni L, Grandi S, Corvaglia L, et al. Effect of posture on brain hemodynamics in preterm newborns not mechanically ventilated. Neonatology. 2010; 97(3): 212-7[DOI][PubMed]
  • 25. Elser HE, Holditch-Davis D, Levy J, Brandon DH. The effects of environmental noise and infant position on cerebral oxygenation. Adv Neonatal Care. 2012; 12 Suppl 5-27[DOI][PubMed]
  • 26. Liao SM, Rao R, Mathur AM. Head Position Change Is Not Associated with Acute Changes in Bilateral Cerebral Oxygenation in Stable Preterm Infants during the First 3 Days of Life. Am J Perinatol. 2015; 32(7): 645-52[DOI][PubMed]
  • 27. Demirel G, Oguz SS, Celik IH, Erdeve O, Dilmen U. Cerebral and mesenteric tissue oxygenation by positional changes in very low birth weight premature infants. Early Hum Dev. 2012; 88(6): 409-11[DOI][PubMed]
  • 28. Pichler G, Urlesberger B, Baik N, Schwaberger B, Binder-Heschl C, Avian A, et al. Cerebral Oxygen Saturation to Guide Oxygen Delivery in Preterm Neonates for the Immediate Transition after Birth: A 2-Center Randomized Controlled Pilot Feasibility Trial. J Pediatr. 2016; 170: 73-8 e1-4[DOI][PubMed]
  • 29. Cerbo RM, Cabano R, Di Comite A, Longo S, Maragliano R, Stronati M. Cerebral and somatic rSO2 in sick preterm infants. J Matern Fetal Neonatal Med. 2012; 25 Suppl 4: 97-100[DOI][PubMed]
  • 30. Tax N, Pichler G, Grossauer K, Pocivalnik M, Zotter H, Raith W, et al. Tilting the head changes cerebral haemodynamics in neonates. Neonatology. 2011; 100(3): 253-9[DOI][PubMed]
  • 31. Hyttel-Sorensen S, Pellicer A, Alderliesten T, Austin T, van Bel F, Benders M, et al. Cerebral near infrared spectroscopy oximetry in extremely preterm infants: phase II randomised clinical trial. BMJ. 2015; 350[DOI][PubMed]
  • 32. Cowan F, Thoresen M. Changes in superior sagittal sinus blood velocities due to postural alterations and pressure on the head of the newborn infant. Pediatrics. 1985; 75(6): 1038-47[PubMed]
  • 33. Emery JR, Peabody JL. Head position affects intracranial pressure in newborn infants. J Pediatr. 1983; 103(6): 950-3[PubMed]
  • 34. Bembich S, Oretti C, Travan L, Clarici A, Massaccesi S, Demarini S. Effects of prone and supine position on cerebral blood flow in preterm infants. J Pediatr. 2012; 160(1): 162-4[DOI][PubMed]
  • 35. Ledwith MB, Bloom S, Maloney-Wilensky E, Coyle B, Polomano RC, Le Roux PD. Effect of body position on cerebral oxygenation and physiologic parameters in patients with acute neurological conditions. J Neurosci Nurs. 2010; 42(5): 280-7[PubMed]
  • 36. van de Bor M, Walther FJ. Cerebral blood flow velocity regulation in preterm infants. Biol Neonate. 1991; 59(6): 329-35[PubMed]
  • 37. Lucking SE, Maffei FA, Tamburro RF, Thomas NJ. Pediatric Critical Care Study Guide: Text and Review. 2012; [DOI]
  • 38. Schrod L, Walter J. Effect of head-up body tilt position on autonomic function and cerebral oxygenation in preterm infants. Biol Neonate. 2002; 81(4): 255-9[PubMed]
  • 39. Petrova A, Mehta R. Alteration in regional tissue oxygenation of preterm infants during placement in the semi-upright seating position. Sci Rep. 2015; 5: 8343[DOI][PubMed]
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