Regional Oxygen Saturation of the Brain and Peripheral Tissue during Birth Transition of Term Infants

Urlesberger, Berndt; Grossauer, Karin; Pocivalnik, Mirjam; Avian, Alexander; Müller, Wilhelm; Pichler, Gerhard

doi:10.1016/j.jpeds.2010.05.013

Cited by 86 publications

(75 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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: 83%

“…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: 68%

See 1 more Smart Citation

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

et al. 2011

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 68%

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

et al. 2011

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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...

show abstract

“…In term infants at birth, cStO 2 rapidly adapts to extrauterine life and after the 7 th minute remains stable. The results are beneficial in terms of demonstration of cerebral oxygenation, documenting the increase in cerebral blood flow in the first minutes of life 25,26 . Karen et al used NIRO-300 TM (Hamamatsu Photonics, Hamamatsu, Japan) and published that newborns delivered by vacuum extraction had significantly higher tissue hemoglobin index (THI) 10 to 15 min after birth.…”

Section: Reference Rangesmentioning

confidence: 93%

Use of near-infrared spectroscopy (NIRS) in cerebral tissue oxygenation monitoring in neonates

2017

View full text Add to dashboard Cite

Near-infrared spectroscopy (NIRS) is a technology capable of non-invasive, continuous measuring of regional tissue oxygen saturation (StO 2 ). StO 2 represents a state of hemodynamic stability, which is influenced by many factors. Extensive research has been done in the field of measuring StO 2 of various organs. The current clinical availability of several NIRS-based devices reflects an important development in prevention, detection and correction of discrepancy in oxygen delivery to the brain and vital organs. Managing cerebral ischemia remains a significant issue in the neonatal intensive care units (NICU). Cerebral tissue oxygenation (cStO 2 ) and cerebral fractional tissue extraction (cFTOE) are reported in a large number of clinical studies. This review provides a summary of the concept of function, current variability of NIRS-based devices used in neonatology, clinical applications in continuous cStO 2 monitoring, limitations, disadvantages, and the potential of current technology.

show abstract

Regional Oxygen Saturation of the Brain and Peripheral Tissue during Birth Transition of Term Infants

Cited by 86 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

Use of near-infrared spectroscopy (NIRS) in cerebral tissue oxygenation monitoring in neonates

Contact Info

Product

Resources

About