Fetal to neonatal transition: what additional information can be provided by cerebral near infrared spectroscopy?

Baik‐Schneditz, Nariae; Schwaberger, Bernhard; Bresesti, Ilia; Fuchs, Hans; Lara, Inmaculada; Britt, Nakstad; Lista, Gianluca; Vento, Máximo; Binder‐Heschl, Corinna; Pichler, Gerhard; Urlesberger, Berndt

doi:10.1038/s41390-022-02081-0

Cited by 3 publications

(4 citation statements)

References 59 publications

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“…27,28 Cerebral oxygenation during perinatal transition also depended on total hemoglobin concentration that showed a significant decrease within the first minutes after birth, cerebral activity, changes in partial pressure of carbon dioxide (hypercapnia was associated with cerebral vasodilation and increased cerebral oxygenation), even low blood glucose levels were associated with an increased crSO 2 . [29][30][31][32] No relevant changes have been demonstrated according to the delivery mode, while delayed umbilical cord clamping may imply a decrease in crSO 2 values. 33,34 Regarding the optimal number of wavelengths required for NIRS monitors, it was considered according to some recent studies, that from three wavelengths onwards a more accurate value was obtained.…”

Section: Discussionmentioning

confidence: 99%

“…However, from 8-10 minutes after birth, despite continuous SpO2 increase, crSO2 reached a plateau and since then started decreasing due to cerebral autoregulation, which cause vasoconstriction and reduce cerebral blood flow 26,27 . Cerebral oxygenation during perinatal transition also depended on total hemoglobin concentration that showed a significant decrease within the first minutes after birth, cerebral activity, changes in partial pressure of carbon dioxide (hypercapnia was associated with cerebral vasodilation and increased cerebral oxygenation), even low blood glucose levels was associated with an increased crSO2 [28][29][30][31] . No relevant changes have been demonstrated according to the delivery mode, while delayed umbilical cord clamping may imply a decrease in crSO2 values [32][33] .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Reference Ranges for Regional Cerebral Oxygen Saturation with Masimo O3 after Birth and Differences with Other Devices

Carnicero,

Carbonero

2024

Am J Perinatol

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- Objective: Cerebral oximetry using near-infrared spectroscopy (NIRS) is a non invasive optical technology widely used in neonatology. Aim of the present studio was to define reference ranges for cerebral tissue oxygen saturation (crSO2) with a new 4 wavelength NIRS device, Masimo O3® oxymeter, during inmediate transition after birth and compare values with those obtained previously with NIRO 200NX®. -Study design: This was a prospective observational study using Masimo O3 device to measure crSO2 and regional cerebral fractional tissue oxygen extraction (cFTOE) in healthy term newborns delivered by primary cesarean section, during the 15 minutes after cord clamping. The neonates who required any medical support were excluded. The NIRS-sensor was placed in the right forehead. Peripheral oxygen saturation and heart rate were continuously measured by pulse oximetry. Previous studies which established centiles for crSO2 with NIRO 200 NX were used to compare. -Results: A total of 44 newborns were included. The median crSO2 and cFTOE (interquartile range) at 2, 5 and 7 minutes was 54% (49-54); 71% (64-86) and 79% (73-84) and 0,25 (0,18-0,33); 0,19 (0,15-0,23) and 0,16 (0,12-0,21), respectively ,with no further changes afterwards. The crSO2 measurements were significantly higher with Masimo O3 compared NIRO-200NX. -Conclusion: The present observational study presented reference ranges for crSO2 and cFTOE measured with Masimo O3 oxymeter during the inmediate neonatal transition. Values obtained with O3 were higher than those obtained with others oxymeters. For this reason, crSO2 is device-specific so it must be known reference values for each oxymeter to define therapeutic interventions based on crSO2 and asses cerebral oxygenation clinical studies.

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Section: Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Reference Ranges for Regional Cerebral Oxygen Saturation with Masimo O3 after Birth and Differences with Other Devices

Carnicero,

Carbonero

2024

Am J Perinatol

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“…Ideally, this assessment should be non-invasive and provide reliable information continuously. Recent research focused on non-invasive cardiac output monitoring (NICOM), and the assessment of end-organ perfusion by using near-infrared spectroscopy (NIRS) ( 2 , 11 ). Berisha et al performed a feasibility study using impedance cardiography for NICOM in asphyxiated piglets to evaluate its potential to improve monitoring and treatment of sick neonates.…”

Section: Introductionmentioning

confidence: 99%

“…These findings suggest that passive pressure-dependent cerebral perfusion was present, indicating an impaired cerebral autoregulation in those compromised preterm neonates during the immediate transition. Those upcoming techniques require further investigation in clinical trials as they potentially identify neonates in need of cardio-circulatory support, and further guide hemodynamic management during immediate fetal-to-neonatal transition ( 2 , 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Editorial: Cardio-circulatory support of neonatal transition

Schwaberger

Pichler²,

Baik‐Schneditz³

et al. 2023

Front. Pediatr.

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The effects of cerebral oximetry in mechanically ventilated newborns: a protocol for the SafeBoosC-IIIv randomised clinical trial

Vestager,

Hansen,

Rasmussen

et al. 2023

Trials

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Background The SafeBoosC project aims to test the clinical value of non-invasive cerebral oximetry by near-infrared spectroscopy in newborn infants. The purpose is to establish whether cerebral oximetry can be used to save newborn infants’ lives and brains or not. Newborns contribute heavily to total childhood mortality and neonatal brain damage is the cause of a large part of handicaps such as cerebral palsy. The objective of the SafeBoosC-IIIv trial is to evaluate the benefits and harms of cerebral oximetry added to usual care versus usual care in mechanically ventilated newborns. Methods/design SafeBoosC-IIIv is an investigator-initiated, multinational, randomised, pragmatic phase-III clinical trial. The inclusion criteria will be newborns with a gestational age more than 28 + 0 weeks, postnatal age less than 28 days, predicted to require mechanical ventilation for at least 24 h, and prior informed consent from the parents or deferred consent or absence of opt-out. The exclusion criteria will be no available cerebral oximeter, suspicion of or confirmed brain injury or disorder, or congenital heart disease likely to require surgery. A total of 3000 participants will be randomised in 60 neonatal intensive care units from 16 countries, in a 1:1 allocation ratio to cerebral oximetry versus usual care. Participants in the cerebral oximetry group will undergo cerebral oximetry monitoring during mechanical ventilation in the neonatal intensive care unit for as long as deemed useful by the treating physician or until 28 days of life. The participants in the cerebral oximetry group will be treated according to the SafeBoosC treatment guideline. Participants in the usual care group will not receive cerebral oximetry and will receive usual care. We use two co-primary outcomes: (1) a composite of death from any cause or moderate to severe neurodevelopmental disability at 2 years of corrected age and (2) the non-verbal cognitive score of the Parent Report of Children’s Abilities-Revised (PARCA-R) at 2 years of corrected age. Discussion There is need for a randomised clinical trial to evaluate cerebral oximetry added to usual care versus usual care in mechanically ventilated newborns. Trial registration The protocol is registered at www.clinicaltrials.gov (NCT05907317; registered 18 June 2023).

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Fetal to neonatal transition: what additional information can be provided by cerebral near infrared spectroscopy?

Cited by 3 publications

References 59 publications

Reference Ranges for Regional Cerebral Oxygen Saturation with Masimo O3 after Birth and Differences with Other Devices

Reference Ranges for Regional Cerebral Oxygen Saturation with Masimo O3 after Birth and Differences with Other Devices

Editorial: Cardio-circulatory support of neonatal transition

The effects of cerebral oximetry in mechanically ventilated newborns: a protocol for the SafeBoosC-IIIv randomised clinical trial

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