Brain haemodynamic effects of nasal continuous airway pressure in preterm infants of less than 30 weeks' gestation

Aim: To evaluate the hypothesis that increasing levels of nasal continuous positive airway pressure (NCPAP) may decrease cerebral blood volume (CBV) and cerebral oxygenation in infants with gestational age (GA) less than 30 weeks. Methods: We prospectively studied a cohort of preterm infants treated with NCPAP using near‐infrared spectroscopy (NIRS). The pressure limit of NCPAP was set at 2, 4, 6 and again 2 cm H2O for 30 min. Results: Changes of pressure levels were not followed by significant changes of oxygenated haemoglobin (O2Hb), deoxygenated haemoglobin (HHb), cerebral intravascular oxygenation (HbD), oxidized‐reduced cytochrome aa3 (CtOx), tissue oxygenation index (TOI), tissue haemoglobin index (THI) and cerebral blood volume (ΔCBV). Conclusion: NCPAP at 2–6 cm H2O pressure levels did not affect cerebral oxygenation and CBV. These findings are reassuring and confirm the safety of NCPAP in preterm infants with GA less than 30 weeks.