Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation?

Frontiers in Pediatrics

article

Corinna Binder-Heschl¹  Gerhard Pichler¹  Alexander Avian³  Bernhard Schwaberger¹  Nariae Baik-Schneditz¹  Lukas Mileder¹  Stefan Heschl⁴  Berndt Urlesberger¹ 

[1] Department of Pediatrics, Division of Neonatology, Medical University of Graz;Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics, Medical University of Graz;Institute for Medical Informatics, Medical University of Graz;Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz

关键词: near infrared spectroscopy;    regional cerebral oxygenation;    respiratory support;    transition period;    preterm neonates;    arterial oxygen saturation;    target saturation;   

DOI  :  10.3389/fped.2019.00274

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective: To investigate if preterm neonates with arterial oxygen saturation (SpO 2 )<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO 2 ), compared to infants reaching the target. Methods: Retrospective analysis of four prospective observational studies. Preterm neonates needing respiratory support during delivery room stabilization were included. Regional cerebral tissue oxygen saturation was measured with near-infrared spectroscopy (NIRS) during the first 15 min after birth along with SpO 2 and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO 2 ≥ 80% (“≥80% group”) and those with a 5-min SpO 2 < 80% (“<80% group”). Groups were compared regarding rcStO 2 , SpO 2 , and HR. Furthermore, we analyzed whether a 5-min SpO 2 < 80% was associated with a rcStO 2 below the 10th percentile at the same time point. Results: 146 neonates were included, with 68 (47%) in the “≥80% group” and 78 (53%) in the “<80% group.” Neonates in the “ <80% group” had a significantly lower rcStO 2 ( p < 0.001). Furthermore, 80.3% of neonates in the “ <80% group” and 23.4% in the “≥80% group” had rcStO 2 values below the 10th percentile at 5 min ( p < 0.001). HR was significantly lower at minute 3 and 4 in the “ <80% group” ( p < 0.002). Conclusion: Preterm infants needing respiratory support, who do not reach the SpO 2 target of 80% at 5 min after birth, show significantly diminished rcStO 2 values compared to neonates reaching the target.

【 授权许可】

CC BY