Clinical paper Impact of bradycardia and hypoxemia on oxygenation in preterm infants requiring respiratory support at birth

RESUSCITATION

卷:164

Article

Bresesti, Ilia^1,2,3  Avian, Alexander⁴  Bruckner, Marlies^1,2,5  Binder-Heschl, Corinna^1,2  Schwaberger, Bernhard^1,2  Baik-Schneditz, Nariae^1,2  Schmoelzer, Georg^2,5,6  Pichler, Gerhard^1,2  Urlesberger, Berndt^1,2 

[1] Med Univ Graz, Div Neonatol, Auenbruggerpl 34-2, A-8036 Graz, Austria

[2] Med Univ Graz, Res Unit Cerebral Dev & Oximetry, Auenbruggerpl 34-2, A-8036 Graz, Austria

[3] ASST FBF Sacco, NICU V Buzzi Childrens Hosp, Via Castelvetro 32, I-20154 Milan, Italy

[4] Med Univ Graz, Inst Med Informat Stat & Documentat, Auenbruggerpl 34-2, A-8036 Graz, Austria

[5] Royal Alexandra Hosp, Neonatal Res Unit, Ctr Studies Asphyxia & Resuscitat, 10240 Kingsway Ave NW, Edmonton, AB T5H 3V9, Canada

[6] Univ Alberta, Dept Pediat, 10240 Kingsway Ave NW, Edmonton, AB T5H 3V9, Canada

关键词: Neonatal resuscitation;    Degree of bradycardia;    Presence of hypoxemia;    Preterm infants;    Respiratory support;    Cerebral oxygen saturation;    Cerebral oxygen delivery;   

DOI  :  10.1016/j.resuscitation.2021.05.004

来源: Elsevier

【 摘 要 】

Aim of the study: Analysis of the impact of bradycardia and hypoxemia on the course of cerebral and peripheral oxygenation parameters in preterm infants in need for respiratory support during foetal-to-neonatal transition. Methods: The first 15 min after birth of 150 preterm neonates in need for respiratory support born at the Division of Neonatology, Graz (Austria) were analyzed. Infants were divided into different groups according to duration of bradycardia exposure (no Bradycardia, brief bradycardia <2 min, and prolonged bradycardia >2 min) and to systemic oxygen saturation (SpO(2)) value at 5 min of life (<80% or >80%). Analysis was performed considering the degree of bradycardia alone (step 1) and in association with the presence of hypoxemia (step 2). Results: In step 1, courses of SpO(2) differed significantly between bradycardia groups (p = 0.002), while courses of cerebral regional oxygen saturation (crStO(2)) and cerebral fractional tissue oxygen extraction (cFTOE) were not influenced (p = 0.382 and p = 0.878). In step 2, the additional presence of hypoxemia had a significant impact on the courses of SpO(2) (p < 0.001), crStO(2) (p < 0.001) and cFTOE (p = 0.045). Conclusion: Our study shows that the degree of bradycardia has a significant impact on the course of SpO(2) only, but when associated with the additional presence of hypoxemia a significant impact on cerebral oxygenation parameters was seen (crStO(2), cFTOE). Furthermore, the additional presence of hypoxemia has a significant impact on FiO(2) delivered. Our study emphasizes the importance of HR and SpO(2) during neonatal resuscitation, underlining the relevance of hypoxemia during the early transitional phase.

【 授权许可】

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