Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

Fauchère, Jean‐Claude; Schulz, Gabriele; Haensse, Daniel; Keller, Esther; Ersch, Jörg; Bucher, Hans Ulrich; Wolf, Martin

doi:10.1016/j.jpeds.2009.09.050

Cited by 57 publications

(40 citation statements)

References 28 publications

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“…Previously, cerebral StO 2 measurements beginning at 3 min of life were reported in healthy term newborn infants with no need of respiratory support after elective Cesarean section. 30,31 The range of cerebral StO 2 observed during spontaneous transition of these infants was similar to the range of cerebral StO 2 that we observed in our VLBW infants despite their immaturity and their need for supportive measures. However, the steady state in these infants were slightly lower than the values observed in the VLBW infants.…”

Section: Discussionsupporting

confidence: 84%

“…However, the steady state in these infants were slightly lower than the values observed in the VLBW infants. 30,31 Higher values of cerebral StO 2 in preterm infants compared with full term infants in the first days of life have been observed in another study. It had been speculated, that this may be related to elevated PCO 2 resulting in increased cerebral perfusion in the immature infants.…”

Section: Discussionmentioning

confidence: 64%

“…If respiratory support was indicated because of low respiratory effort a nasopharyngeal tube was inserted 3 to 4 cm into one nostril and nasal continuous positive airway pressure was applied at 5 cm H 2 O at FiO 2 0.4 using a F120 neonatal ventilator (Stephan, Gackenbach, Germany). If the heart rate remained below 100 bpm or SpO 2 remained <70% without increase, up to three sustained inflations were applied for lung recruitment at increasing pressures (20,25,30 cm H 2 O) for 15 s each, followed by nasopharyngeal intermittent mandatory ventilation or nasal continuous positive airway pressure as described before. 23,24 FiO 2 was adjusted to maintain SpO 2 at 80 to 92%.…”

Section: Neonatal Resuscitationmentioning

confidence: 99%

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Brain oxygenation monitoring during neonatal resuscitation of very low birth weight infants

et al. 2011

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Objective: To explore if regional cerebral tissue oxygen saturation monitoring by near-infrared spectroscopy (NIRS) is feasible during neonatal resuscitation of very low birth weight (VLBW) infants after birth.Study Design: Cerebral tissue oxygen saturation was measured by NIRS in 51 VLBW infants (mean gestational age: 27.8 weeks) during the first 10 min after delivery.Result: A regional cerebral tissue oxygen saturation signal was available after a median (interquartile range) age of 52 (44 to 68) s. In three infants the signal was obtained after 10 min of age. After delivery cerebral tissue oxygen saturation rose continuously from 37 (31 to 49) % at 1 minute of age and reached a steady state in the range of 61 to 84% B7 min after birth. Percentiles of cerebral tissue oxygen saturation of this cohort of preterm infants are given. Conclusion:Cerebral tissue oxygen saturation monitoring is feasible during neonatal resuscitation of VLBW infants within the first minutes of life.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 64%

Section: Neonatal Resuscitationmentioning

confidence: 99%

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Brain oxygenation monitoring during neonatal resuscitation of very low birth weight infants

et al. 2011

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“…Recently, data on rcSO 2 have become available in healthy term infants during immediate postnatal adaptation (34 -36). In these infants, cerebral oxygenation rose continuously and reached a plateau after around 7-8 min after birth without any support of respiration (34,36). In this study, rcSO 2 remained low and heart rate and SpO 2 continued to decrease until respiratory support was initiated.…”

Section: Discussionsupporting

confidence: 45%

Cerebral Oxygenation in Very Low Birth Weight Infants Supported With Sustained Lung Inflations After Birth

et al. 2011

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Sustained lung inflations (SIs) immediately after birth might decrease the need for subsequent mechanical ventilation in preterm infants. However, effects of SIs on oxygenation and hemodynamics are undetermined. Our aim was to study immediate effects of SIs on heart rate, arterial oxygen saturation, and cerebral tissue oxygen saturation in preterm infants supported with SIs after birth for lung recruitment. Heart rate, arterial oxygen saturation, and cerebral tissue oxygen saturation using near infrared spectroscopy was measured in 24 preterm infants of 28.0 (26.6 -29.3) wk GA [median (interquartile range)] during resuscitation using up to three SIs of 20, 25, and 30 cm H 2 O of 15 s duration each followed by nasal continuous positive airway pressure (CPAP) as first line approach for respiratory support. During positioning and suctioning immediately after delivery infants became progressively hypoxemic and bradycardic before respiratory support was initiated. In 18 infants (75%), more than one SI were applied. During the last SIs, there was a rapid increase in the infants' heart rate and an increase in cerebral tissue oxygen saturation. Arterial saturation increased with slight delay. In conclusion, effective last sustained inflations increase heart rate and cerebral tissue oxygen saturation to be followed by an increase in arterial saturation. (Pediatr Res 70: 176-180, 2011) R eplacement of amniotic fluid by air to establish a gaseous functional residual capacity (FRC) is essential for successful transition after birth (1,2). Term and preterm infants begin to breathe after delivery with deep inspirations and braking of expirations (3-7). Closure of the larynx during expiration may help the newborn to maintain FRC (6,8).Clinical and laboratory observations have shown that the application of continuous positive airway pressure (CPAP) helps to establish a gaseous FRC and improve gas exchange (9 -11). In a preterm animal model, the application of SIs of 10 to 20 s duration did further enhance movement of amniotic fluid into the distal airways resulting in an increased FRC and more uniform lung aeration than CPAP alone (10,12).Clinical studies suggest that the use of SIs in preterm infants may help to reduce the need for intubation and mechanical ventilation without adverse effects (13,14). A lower rate of bronchopulmonary dysplasia (BPD) was reported in one study when SIs followed by nasal CPAP was compared with bag and mask ventilation (13). However, these trials have limited power to prove safety of SIs.Possible sequelae of SIs include overdistension of the lung and compromise of hemodynamics as a result of the impaired systemic venous return and decreased pulmonary blood flow caused by the increase in intrathoracic pressure during the procedure (15-18). Cerebral blood flow may be impaired resulting in brain damage in the preterm infant (19 -21). Impaired cerebral venous flow may predispose to intraventricular hemorrhage (IVH) (22) or periventricular hemorrhagic infarction (23,24).Near-infrared spectros...

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“…Pulse oximetry and cerebral oxygenation monitoring utilize near infrared spectroscopy (NIRS) to monitor changes in concentrations of chromophores (oxyhemoglobin and deoxyhemoglobin) (33,34). Photons from the near infrared spectrum are absorbed by chromophores.…”

Section: Near Infrared Spectroscopy (Nirs)mentioning

confidence: 99%

Noninvasive Methods to Evaluate Bladder Obstruction in Men

Chughtai

Lee

et al. 2013

Int. braz j urol.

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Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

Cited by 57 publications

References 28 publications

Brain oxygenation monitoring during neonatal resuscitation of very low birth weight infants

Brain oxygenation monitoring during neonatal resuscitation of very low birth weight infants

Cerebral Oxygenation in Very Low Birth Weight Infants Supported With Sustained Lung Inflations After Birth

Noninvasive Methods to Evaluate Bladder Obstruction in Men

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