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The aim of our study was to compare, using near-infrared spectroscopy (NIRS), the effects on cerebral intracellular oxygenation and cerebral blood volume (CBV) of closed endotracheal suctioning (CS), which permits continuous ventilation of the patient, with open endotracheal suctioning (OS), which requires disconnection from the ventilator. Eleven preterm infants were studied. Each patient underwent one CS, followed, after 60 min, by one OS, or vice versa, three times during the same day. Modifications in CBV and oxidized cytochrome oxidase (CytO₂) were continuously detected by NIRS; arterial oxygen saturation (SaO₂) heart rate (HR), transcutaneous carbon dioxide tension and mean arterial blood pressure were simultaneously recorded. Significant reductions in HR and SaO₂ were observed following OS; the magnitude and duration of these negative effects of suctioning were significantly reduced with CS. In addition, the decrease in CBV was more pronounced than following CS. No changes in CytO₂ concentration were seen.

Compared to the 1989 ILAE classification, which allowed a syndromic diagnosis in only 6/94 patients, the remaining being classified as Epilepsies and Syndromes undetermined whether focal or generalized, the 2001 ILAE diagnostic scheme, applied at the end of the neonatal period, offers a variety of approaches to classification, allowing an early distinction between epilepsy and single or isolated clusters of seizures, with therapeutic and prognostic implications.