Blood Glucose and Cerebral Tissue Oxygenation Immediately after Birth—An Observational Study

Matterberger, Christian; Baik‐Schneditz, Nariae; Schwaberger, Bernhard; Schmölzer, Georg M.; Mileder, Lukas P.; Pichler-Stachl, Elisabeth; Urlesberger, Berndt; Pichler, Gerhard

doi:10.1016/j.jpeds.2018.05.008

Cited by 20 publications

(19 citation statements)

References 23 publications

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“…However, we did not find a significant correlation in our regression analysis regarding neonatal hyperglycemia and low cerebral oxygenation, and no correlation was found with the other blood gas-related indicators. This finding is in contrast with Mattersberger’s result 29 that blood glucose concentration was associated with cerebral oxygenation during the immediate transition after birth in neonates born at term and preterm. This might be because of the different testing time points between the 2 studies.…”

Section: Discussioncontrasting

confidence: 99%

<p>Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study</p>

Xue¹,

Wu²,

Yao³

et al. 2020

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Purpose The physiologic transition from a fetus to a neonate is composed of a series of complex processes that include changes in cerebral tissue oxygenation saturation (cSO 2 ). Monitoring this process is of great importance. This study aimed to define the cSO 2 reference interval in neonates without medical support, extending the measurements until 1 hour after birth, and to determine the incidence of abnormally low or high regional cerebral oxygenation during the neonatal transition. Patients and Methods A total of 418 neonates delivered by cesarean section were enrolled. Near-infrared spectroscopy was used to monitor cerebral oxygenation. Results We found that cSO 2 of the non-oxygen-inhaled intrathecal anesthesia in neonates without medical support increased from about 49.0% in the second minute. Most of them reached cSO 2 relative stabilization at 55.7–81.0% between 7 and 8 minutes after birth. One hour after birth, newborn cSO 2 was maintained at 78.0–87.0%. The low cSO 2 rate among babies born under intrathecal anesthesia with and without maternal oxygen inhalation during cesarean sections was approximately 4.5% and 9.0%, respectively. Conclusion We reported the trend in cSO 2 from 2 minutes after birth to 1 hour in the neonatal nursing room and determined the incidence of abnormal regional cSO 2 during this neonatal transition period. Anesthesiologists should pay special attention to the risk of cSO 2 abnormalities in newborns when managing pregnant women with comorbidities.

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Section: Discussioncontrasting

confidence: 99%

<p>Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study</p>

Xue¹,

Wu²,

Yao³

et al. 2020

DDDT

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“…Twelve studies were identified, which describe blood glucose level measurements in combination with cerebral NIRS measurements ( Table 1) (6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Four studies describe an association (6,12,14,16) between blood glucose levels and cerebral oxygenation. All studies demonstrate a negative correlation.…”

Section: Blood Glucose Level and Cerebral Oxygenationmentioning

confidence: 99%

“…A recently published multicenter trial using cerebral NIRS monitoring to reduce the burden of cerebral hypoxia in preterm neonates described beside cardiovascular and respiratory interventions also interventions based on blood glucose levels (5). Another recently published study describe an association between blood glucose level and cerebral oxygenation in preterm and term neonates immediately after birth (6). Further, lactate as a product of anaerobic metabolism might be associated with hypoxic conditions in the tissue.…”

Section: Introductionmentioning

confidence: 99%

Blood Glucose and Lactate Levels and Cerebral Oxygenation in Preterm and Term Neonates—A Systematic Qualitative Review of the Literature

et al. 2020

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Background: Cerebral oxygenation monitored non-invasively by near-infrared spectroscopy (NIRS) is of increasing interest in neonatal care. Cerebral oxygenation is determined by cerebral oxygen delivery and cerebral oxygen consumption. Oxygen delivery as well as oxygen consumption might be influenced by metabolic parameters like blood glucose and lactate. Objective: The aim of the present systematic qualitative review is therefore to identify and summarize all studies, which describe cerebral oxygenation measured with NIRS and blood glucose and/or blood lactate levels in neonates. Data sources: A systematic search of Ovid Embase and PubMed was performed. Search terms included near-infrared spectroscopy, fractional tissue oxygen extraction, cerebral tissue oxygen saturation, regional cerebral tissue oxygen saturation, oxygenation, term, and preterm neonates, cesarean delivery, transition, after-birth, newborn, vaginal delivery, cesarean delivery, baby, neonatal transition, metabolism, lactate, glucose, and blood glucose level. Study selection/data synthesis: Studies analyzing cerebral oxygenation and blood glucose and/or blood lactate levels in neonates were included. Animal studies, duplicates, or studies in non-English language were excluded. Results: Twenty-five studies were identified that describe blood glucose and/or blood lactate levels as primary or secondary outcome parameters with additional measured cerebral oxygenation by NIRS in neonates. Twelve studies were included with blood glucose measurements: four described an association between blood glucose levels and cerebral oxygenation, two show no association, and six do not report on possible associations. Eighteen studies were included with lactate measurements: one describe an association between lactate levels and cerebral oxygenation, while three show no association and 14 do not report on possible associations.

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“…Видно, что максимальная сатурация кислорода и минимальная ФТОЭ наблюдаются во время ортодоксальной фазы сна, когда [17,26,30,34], показатели мониторинга церебральной оксиметрии в первые дни жизни противоречивы. Так, одни авторы свидетельствуют, что CrSO 2 и ФТОЭ у доношенных детей составляют соответственно 83,0 ± 7,7% и 0,14 ± 0,08%, не отличаются от таковых у недоношенных и коррелируют с уровнем глюкозы в крови [20]. Другие указывают, что у здоровых доношенных детей в первые сутки жизни CrSO 2 равна 62,0 ± 2,0% и не изменяется в последующие 5 дней жизни [38].…”

Section: результаты исс ледований и обс у ж дниеunclassified

“…Анализируя уже имеющиеся результаты церебральной оксиметрии, авторы указывают на значительные не только индивидуальные колебания показателей, но и в процессе мониторинга у каждого отдельного ребенка, что ограничивает внедрение метода в практику [14,37]. Следует отметить, что оценка показателей оксиметрии проводилась без учета функционального состояния новорожденного в момент исследования [13,20]. Однако известно, что становление биоэлектрической активности мозга, механизмов регуляции системного и мозго-вого кровообращения, дыхания, ритма сердечной деятельности и других жизненно важных функций плода и новорожденного тесно связано с формированием в раннем онтогенезе циклической организации сна [1].…”

Section: Introductionunclassified

The feature of brain oxygenation in the sleep cycle of healthy newborn babies

et al. 2020

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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.

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Blood Glucose and Cerebral Tissue Oxygenation Immediately after Birth—An Observational Study

Cited by 20 publications

References 23 publications

<p>Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study</p>

<p>Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study</p>

Blood Glucose and Lactate Levels and Cerebral Oxygenation in Preterm and Term Neonates—A Systematic Qualitative Review of the Literature

The feature of brain oxygenation in the sleep cycle of healthy newborn babies

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