Cerebral Oxygenation During Transition and Amplitude-Integrated Electroencephalography Signals: An Ancillary Study to the COSGOD-III Trial

Abstract

Aim: The COSGOD III trial was designed to guide oxygen delivery by cerebral near infrared spectroscopy (NIRS) in preterm neonates during the immediate transition after birth and showed a non-significant increase of 4.3% in survival without cerebral injury compared to the control group. This ancillary observational study investigated the effect of cerebral oximetry on electrocortical activity assessed by amplitude-integrated electroencephalography (aEEG). Methods: aEEG from three centres participating in the COSGOD III trial was evaluated for the total maturation score (TMS) and its four individual component scores, the visual background pattern and sleep–wake cycling. Results: We included 147 preterm infants with a mean gestational age of 28.1 weeks and a mean birth weight of 1020 g: 70 in the NIRS group, 77 in the control group. We found significantly higher total maturation scores, more mature sleep–wake cycles, and mature background patterns in the NIRS group compared to the control group. Conclusion: In the present cohort, NIRS-guided oxygen delivery combined with dedicated treatment guidelines during the immediate transition after birth showed an impact on electrocortical activity in the neonatal period. Whether this improvement in maturational aspects of the aEEG is also associated with better outcome needs to be evaluated in the long term.