Cerebral haemorrhage in preterm neonates: does cerebral regional oxygen saturation during the immediate transition matter?

Baik, Nariae; Urlesberger, Berndt; Schwaberger, Bernhard; Schmölzer, Georg M.; Avian, Alexander; Pichler, Gerhard

doi:10.1136/archdischild-2014-307590

Cited by 73 publications

(51 citation statements)

References 33 publications

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“…We can only speculate that the different algorithms calculating values from measured changes in light absorption might be responsible for these differences. Taking this correlation into account, the present centiles are consistent with the crSO 2 centiles published by Pichler and colleagues [6]. In the present study, the 50th centile of cTOI at 2 min was higher compared to the 50th centile of crSO 2 [6], and remained higher until minute 5.…”

Section: Discussionsupporting

confidence: 81%

“…These crSO 2 and cFTOE reference ranges were defined using the neonatal sensor of INVOS 5100C cerebral/somatic oximeter (Covidien, Boulder, Colo., USA). Two observational studies have reported on preterm infants with low crSO 2 values during the immediate transition that subsequently developed intraventricular haemorrhage [3,6]. A recent comparison of INVOS and NIRO 200NX (NIRO, Hamamatsu, Japan), both widely used NIRS devices in neonates, reported that crSO 2 values measured with INVOS are about 10% higher compared to the cerebral tissue oxygenation index (cTOI), which was measured with the NIRO 200NX [7].…”

Section: Introductionmentioning

confidence: 99%

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Reference Ranges for Cerebral Tissue Oxygen Saturation Index in Term Neonates during Immediate Neonatal Transition after Birth

Baik¹,

Urlesberger²,

Schwaberger³

et al. 2015

Neonatology

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Background: Non-invasive monitoring of the brain with near-infrared spectroscopy (NIRS) during immediate transition after birth is of growing interest. Objective: The aim of this work was to define reference ranges and centile charts for a regional cerebral tissue oxygenation index (cTOI), measured with the NIRO 200NX (NIRO, Hamamatsu, Japan), and cerebral fractional tissue oxygen extraction (cFTOE) during the first 15 min after birth in preterm and term neonates without any medical support. Methods: cTOI was measured with the NIRO 200NX during the first 15 min after delivery via Caesarean section in preterm and term infants. The NIRS-sensor was placed on the right forehead. Peripheral arterial oxygen saturation (SpO₂) and heart rate were continuously measured by pulse oximetry. cFTOE was calculated out of cTOI and SpO₂. Neonates with a requirement for any medical support were excluded. Results: A total of 230 neonates were enrolled, from which 90 had to be excluded. Therefore, 140 term neonates were included and data were used to define reference ranges and centile charts. The 50th centile (10th to 90th centiles) of cTOI was 56% (39-75) at 2 min, 66% (50-78) at 5 min, 75% (62-85) at 10 min and 73% (61-84) at 15 min after birth. The 50th centile of cFTOE was 0.24 (0.11-0.44) at 2 min, 0.20 (0.10-0.35) at 5 min, 0.21 (0.09-0.35) at 10 min and 0.24 (0.13-0.37) at 15 min after birth. Conclusion: The present observational study adds the reference ranges and centile charts of cTOI measured with the NIRO 200NX and cFTOE calculated out of cTOI and SpO₂ in neonates during the immediate neonatal transition. Centiles for each instrument will be necessary for future clinical application, since the differences between cTOI and cerebral regional tissue oxygen saturation measured with INVOS 5100C change with increasing regional oxygenation.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Reference Ranges for Cerebral Tissue Oxygen Saturation Index in Term Neonates during Immediate Neonatal Transition after Birth

Baik¹,

Urlesberger²,

Schwaberger³

et al. 2015

Neonatology

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“…21 Perhaps more significantly, lower levels of cerebral oxygenation have been associated with poor brain outcomes. [22][23][24][25][26] Future work should use a predefined strategy for data analysis, e.g., drawing a receiver-operating curve for the prediction of severe brain injury for varying levels of cerebral hypoxic burden. This could help the construction of the rationale for one rather than another threshold for intervention.…”

Section: Safe Ranges Based On Association With Brain Injurymentioning

confidence: 99%

Cerebral oximetry in preterm infants: an agenda for research with a clear clinical goal

et al. 2016

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Abstract. Preterm birth constitutes a major cause of death before 5 years of age and it is a major cause of neurodevelopmental impairment across the world. Preterm infants are most unstable during the transition between fetal and newborn life during the first days of life and most brain damage occurs in this period. The brain of the preterm infant is accessible for tissue oximetry by near-infrared spectroscopy. Cerebral oximetry has the potential to improve the long-term outcome by helping to tailor the support of respiration and circulation to the individual infant's needs, but the evidence is still lacking. The goals for research include testing the benefit and harms of cerebral oximetry in large-scale randomized trials, improved definition of the hypoxic threshold, better understanding the effects of intensive care on cerebral oxygenation, as well as improved precision of oximeters and calibration among devices or standardization of values in the hypoxic range. These goals can be pursued in parallel. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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“…Although pulse oximetry and electrocardiogram enable monitoring of heart rate continuously, they do not provide information about potentially compromised cardiocirculatory status influencing oxygen transport to tissue. Besides cardiocirculatory monitoring, there is growing interest to monitor the brain during this vulnerable phase, as the brain is sensitive to hypoxia-ischemia and its damage can result in poor short- and long-term neurological outcome [8]. …”

Section: Introductionmentioning

confidence: 99%

Blood Pressure during the Immediate Neonatal Transition: Is the Mean Arterial Blood Pressure Relevant for the Cerebral Regional Oxygenation?

et al. 2017

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Background: Measurement of mean arterial blood pressure (MABP) is feasible during neonatal transition. Objective: The objective of this study was to investigate a potential influence of MABP on the cerebral regional oxygen saturation (crSO₂) in preterm and term infants during the immediate neonatal transition. Materials and Methods: Preterm and term infants were included in this observational study. The crSO₂ was measured by near-infrared spectroscopy with the INVOS 5100C (Somanetics Corp., Troy, MI, USA) during the immediate neonatal transition (15 min after birth). The near-infrared spectroscopy sensor was applied to the left forehead. Furthermore, a pulse oximeter was applied to monitor arterial oxygen saturation (SpO₂) and heart rate (HR). Fifteen minutes after birth, blood pressure was measured noninvasively at the left upper arm. Cerebral fraction tissue oxygen extraction (cFTOE) was calculated from SpO₂ and crSO₂. To investigate a potential association between crSO₂/cFTOE and MABP, we performed a correlation analysis. Results: A total of 462 preterm and term infants (186/292) were included. Mean gestational age was 31.0 ± 3.5 weeks for preterm infants and 38.9 ± 0.8 weeks for full term infants. Mean birth weight was 1.591 ± 630 g in preterm infants and 3.331 ± 461 g in term infants. There was a significant negative correlation between MABP and cFTOE (ρ = -0.19, p = 0.03) in preterm infants but not in term infants (ρ = 0.05, p = 0.39). There was no significant correlation between MABP and crSO₂ in either group. Conclusion: MABP has an impact on cerebral oxygenation in preterm infants. Therefore, blood pressure monitoring during the immediate neonatal transition might be relevant for improving cerebral oxygenation especially in preterm infants.

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Cerebral haemorrhage in preterm neonates: does cerebral regional oxygen saturation during the immediate transition matter?

Cited by 73 publications

References 33 publications

Reference Ranges for Cerebral Tissue Oxygen Saturation Index in Term Neonates during Immediate Neonatal Transition after Birth

Reference Ranges for Cerebral Tissue Oxygen Saturation Index in Term Neonates during Immediate Neonatal Transition after Birth

Cerebral oximetry in preterm infants: an agenda for research with a clear clinical goal

Blood Pressure during the Immediate Neonatal Transition: Is the Mean Arterial Blood Pressure Relevant for the Cerebral Regional Oxygenation?

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