Noninvasive monitoring brain oxygenation with near-infrared spectroscopy (NIRS) is becoming a widely used in neonatology for determine the optimal target oxygen saturation during resuscitation of newborns, but its use in clinical practice for diagnostics and prognosis perinatal pathology is limited because intra and especially interpatient variability are too large for this aim. This study aimed to determine cerebral oximetry values during the sleep cycle and wakefulness in healthy full term newborns. 38 newborns (gestational age 38 weeks were included in this study (22 after normal birth I group and 16 after cesarean section). Near-infrared spectroscopy (CrSO2) from left fronto-parietal region was recorded in synchrony with polysomnography. Continuous cerebral CrSO2 were measured using near-infrared spectroscopy (Somanetic INVOS 5100C, USA). Fraction tissue oxygen extraction (FTOE) was calculated using SaO2 (pulse oximeter Radical Masimo) and CrSO2 (FTOE = (SаO2 CrSO2)/SаO2). CrSO2 and SаO2 were analyzed during 15 minutes polysomnography-defined quiet, active sleep and wakefulness (defined according to standard guidelines). The results: cerebral oxygen saturation varies with sleep-wake states: during active sleep (74,18 0,75%) was similar to the value in wakefulness (75,6 1,0%) and smaller than in quiet sleep (81,93 1,74%, р 0,001), but FTOE during active sleep was significantly higher (0,221 0,008% and 0,129 0,005%, p 0,001). There were no differences of rates between groups. The high oxygen consumption during REM sleep supports its role during postnatal brain functional development. The use of NIRS taking into account sleep structure will be new method for diagnostic and prognosis perinatal pathology CNS.
The noninvasive monitoring by near-infrared spectroscopy (NIRS) is the perspective method for early diagnostics of the perinatal brain disorders.Aim. We have studied cerebral oximetry values during the sleep-wake cycle in full-term newborns with intrauterine growth retardation (IUGR).Material and methods. 15 newborns with IUGR were included in the research group, and 38 newborns in the control group. Cerebral oximetry (CrS0 2 ) was measured by NIRS (Somanetic INVOS 5100C, USA) from the left frontoparietal region and was recorded simultaneously by the polysomnography. The fraction of the tissue oxygen extraction (FTOE) was calculated by using SaO 2 (pulse oximeter Radical "Masimo") and CrS0 2 . It was analyzed for 15 minutes by polysomnography-defined: quiet, active sleep, and wake.Results and discussion. Cerebral oxygen saturation in newborns with IUGR were significantly higher during sleep and wake. Nevertheless, FTOE was considerably lower in the research group than in the control group. The number of erythrocytes with an optimal activity in the research group was 42.8±2.3% versus 60.1±1.2% in control newborns (p<0.05). The low oxygen consumption during the active phase of the first cycle of the sleeping (REM) sleep and wake is indicators of the perinatal defeat of brain functional development.Conclusion. The usage of NIRS will be a new method for the diagnostic and prognosis of the perinatal pathology of the brain.
BACKGROUND: The high frequency of neurological and mental diseases in children who had intrauterine retardatiojn development indicates the need to study specific markers of disorders of fetal brain functional development, in particular, the state of the serotonergic system, which plays a key role in the morpho-functional development of the brain in early ontogenesis. AIM: To study the content of serotonin in full-term newborns with intrauterine development delay in comparison with quantitative and qualitative characteristics of sleep. MATERIALS AND MЕTHODS: The main group consisted of 26 newborns, whose intrauterine development took place in conditions of chronic placental insufficiency, which led to the formation of an asymmetric form of intrauterine retardatiojn development. The control group consisted of 72 healthy newborns from healthy mothers without pregnancy complications. Children of each group are divided into three subgroups depending on gestational age: I 37, II 38, III 3940 weeks. In all children, 712 hours after birth, an electropoligram of sleep was recorded (an electroencephalograph of the company Mizar, Russia) and its quantitative and qualitative analyses were carried out, highlighting the orthodox, paradoxical phase and undifferentiated state. The serotonin content was determined in platelet-rich plasma of blood from the umbilical cord vein after birth, as well as in a platelet suspension prepared from venous blood taken on the first day of life. The content of serotonin in platelets was judged by the indicator obtained by dividing the amount of serotonin in the platelet suspension by the platelet level. The amount of serotonin was determined by high-performance liquid chromatography with electrochemical detection. Statistical analysis was performed using the Statistica 6 program (Statsoft Inc, USA). RESULTS: We report here a low content of serotonin in platelet-rich plasma and platelets of newborns with intrauterine growth retardation and the absence of its normal increase in weeks 3739 of intrauterine development, as well as a violation of the genetic programming for the sleep-wake cycle organization. CONCLUSIONS: Assessment of the serotonin-producing system of the brain in comparison with the newborn sleep pattern can serve as a diagnostic marker of brain damage and substantiate the need for timely application of neuroprotection.
Relevance: The growth of neuropsychiatric diseases caused by perinatal pathology indicates the need to study the biochemical markers of brain damage in the newborn for the timely prevention of adverse consequences. Serotonin in early ontogenesis provides intensive development of neuronal structures and cortical networks involved in the mechanisms of formation of cyclic sleep organization a fine criterion of morphofunctional development of the brain. aim: The aim of the work is to study the content of serotonin in healthy full-term newborns in comparison with the quantitative and qualitative characteristics of the electropoligraphic sleep pattern. Material and methods: 84 healthy newborns were examined, which, depending on the gestational age, were divided into 3 groups: I 37 weeks (20 people), II 38 weeks (24 people), III 39-40 weeks (40 people). The content of serotonin in platelet-rich plasma of blood from the umbilical cord vein and in platelet suspension prepared from venous blood taken from mothers and children on the first day of life and again on day 5 was determined by high-performance liquid chromatography with electrochemical detection. A quantitative and qualitative analysis of the sleep electropoligram was performed 7-12 hours after birth. Results: The content of serotonin in platelet-rich plasma in umbilical cord blood in children does not depend on the method of birth, is 2 times lower than in the venous blood of mothers (0.379 0.116 microns/l, versus 0.756 0.200 microns/l, but there is a high correlation between the indicators (r = 0.8, p 0.05). At the gestational age of 39-40 weeks, the level of serotonin in platelet-rich plasma and in venous blood platelets is significantly higher than in those born at 37 weeks. In the latter, the increase in the content of serotonin in platelets continues after birth (at day 1, 0.539 0.149 nM/109 Tr, and on day 5 0.846 0.094 nM/109 Tr; p 0.05), whereas the indicators for those born at 39-40 weeks of pregnancy. They do not change (0.797 0.190 nM/109 Tr and 0.749 0.142 nM/109 Tr, respectively). A significant increase in the content of serotonin in the platelet-rich plasma and in the platelets of the child in the period from 37 to 39 weeks, both during intrauterine development and in the first days of life, correlates with an increase in the representation of the orthodox phase in the sleep cycle. Conclusion: The general pattern of changes in serotonin content and cyclic sleep organization in the early neonatal period in healthy newborns, depending on gestational age, indicates the possibility of using the obtained standard values of serotonin as a biochemical marker of functional brain development.
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