Transitional Changes in Cerebral Blood Volume at Birth

Schwaberger, Bernhard; Pichler, Gerhard; Binder‐Heschl, Corinna; Baik, Nariae; Avian, Alexander; Urlesberger, Berndt

doi:10.1159/000437347

Cited by 109 publications

(31 citation statements)

References 21 publications

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“…The observed THb was stable over the 15-min monitoring period. As changes in arterial haemoglobin concentration are negligible, a clear decrease or increase in cerebral blood volume is not evident from these data, in contrast to the findings of Schwaberger et al [27]. For all three FD-NIRS parameters, there were no significant differences between neonates with and without the need for respiratory support.…”

Section: Discussioncontrasting

confidence: 86%

Comparison of frequency-domain and continuous-wave near-infrared spectroscopy devices during the immediate transition

et al. 2020

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Background: Non-invasive monitoring of cerebral tissue oxygen saturation (rcSO 2) during transition is of growing interest. Different near-infrared spectroscopy (NIRS) techniques have been developed to measure rcSO 2. We compared rcSO 2 values during the immediate transition in preterm neonates measured with frequency-domain NIRS (FD-NIRS) with those measured with continuous-wave NIRS (CW-NIRS) devices in prospective observational studies. Methods: We compared rcSO 2 values measured with an FD-NIRS device during the first 15 min after birth in neonates with a gestational age ≥ 30 weeks but < 37 weeks born at the Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands, with similar values measured with a CW-NIRS device in neonates born at the Medical University of Graz, Austria. Mixed models were used to adjust for repeated rcSO 2 measurements, with fixed effects for time (non-linear), device, respiratory support and the interaction of device and respiratory support with time. Additionally, parameters such as total haemoglobin concentration and oxygenated and deoxygenated haemoglobin concentrations measured by FD-NIRS were analysed. Results: Thirty-eight FD-NIRS measurements were compared with 58 CW-NIRS measurements. The FD-NIRS rcSO 2 values were consistently higher than the CW-NIRS rcSO 2 values in the first 12 min, irrespective of respiratory support. After adjustment for respiratory support, the time-dependent trend in rcSO 2 differed significantly between techniques (p < 0.01). Conclusion: As cerebral saturation measured with the FD-NIRS device differed significantly from that measured with the CW-NIRS device, differences in absolute values need to be interpreted with care. Although FD-NIRS devices have technical advantages over CW-NIRS devices, FD-NIRS devices may overestimate true cerebral oxygenation and their benefits might not outweigh the usability of the more clinically viable CW-NIRS devices.

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Section: Discussioncontrasting

confidence: 86%

Comparison of frequency-domain and continuous-wave near-infrared spectroscopy devices during the immediate transition

et al. 2020

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“…Recently, a significant decrease in CBV within the first 15 minutes of life in healthy term infants was demonstrated by our study group [ 27 ]. We hypothesized that changes in blood gases during this time period are the main cause for our observation.…”

Section: Discussionmentioning

confidence: 81%

Do Sustained Lung Inflations during Neonatal Resuscitation Affect Cerebral Blood Volume in Preterm Infants? A Randomized Controlled Pilot Study

et al. 2015

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BackgroundSustained lung inflations (SLI) during neonatal resuscitation may promote alveolar recruitment in preterm infants. While most of the studies focus on respiratory outcome, the impact of SLI on the brain hasn’t been investigated yet.ObjectiveDo SLI affect cerebral blood volume (CBV) in preterm infants?MethodsPreterm infants of gestation 28 weeks 0 days to 33 weeks 6 days with requirement for respiratory support (RS) were included in this randomized controlled pilot trial. Within the first 15 minutes after birth near-infrared spectroscopy (NIRS) measurements using ‘NIRO-200-NX’ (Hamamatsu, Japan) were performed to evaluate changes in CBV and cerebral tissue oxygenation. Two groups were compared based on RS: In SLI group RS was given by applying 1–3 SLI (30 cmH2O for 15 s) continued by respiratory standard care. Control group received respiratory standard care only.Results40 infants (20 in each group) with mean gestational age of 32 weeks one day (±2 days) and birth weight of 1707 (±470) g were included. In the control group ΔCBV was significantly decreasing, whereas in SLI group ΔCBV showed similar values during the whole period of 15 minutes. Comparing both groups within the first 15 minutes ΔCBV showed a tendency toward different overall courses (p = 0.051).ConclusionThis is the first study demonstrating an impact of SLI on CBV. Further studies are warranted including reconfirmation of the present findings in infants with lower gestational age. Future investigations on SLI should not only focus on respiratory outcome but also on the consequences on the developing brain.Trial RegistrationGerman Clinical Trials Register DRKS00005161 https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do

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“…Several studies have reported on the measurement of cerebral oxygenation via the tissue oxygenation index or regional saturation of oxygen (rSO 2 ) in neonates during the immediate transition after birth using NIRS [2][3][4][5][6][7][8]. Furthermore, NIRS can measure changes in venous Hb concentration (tHb) and cerebral blood volume (CBV), with some work showing a decrease in CBV in term neonates in the first 15 min after birth [9]. However, commonly used NIRS modalities, such as continuous wave spectroscopy, which only measures changes in the Hb concentration, and spatially resolved spectroscopy does not provide CBV but tissue oxygen saturation [1].…”

Section: Introductionmentioning

confidence: 99%

Measurement of the Absolute Value of Cerebral Blood Volume and Optical Properties in Term Neonates Immediately after Birth Using Near-Infrared Time-Resolved Spectroscopy: A Preliminary Observation Study

et al. 2019

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The aim of this study was to use near-infrared time-resolved spectroscopy (TRS) to determine the absolute values of cerebral blood volume (CBV) and cerebral hemoglobin oxygen saturation (ScO2) during the immediate transition period in term neonates and the changes in optical properties such as the differential pathlength factor (DPF) and reduced scattering coefficient (μs’). CBV and ScO2 were measured using TRS during the first 15 min after birth by vaginal delivery in term neonates who did not need resuscitation. Within 2–3 min after birth, CBV showed various changes such as increases or decreases, followed by a gradual decrease until 15 min and then stability (mean (SD) mL/100 g brain: 2 min, 3.09 (0.74); 3 min, 3.01 (0.77); 5 min, 2.69 (0.77); 10 min, 2.40 (0.61), 15 min, 2.08 (0.47)). ScO2 showed a gradual increase, then kept increasing or became a stable reading. The DPF and μs’ values (mean (SD) at 762, 800, and 836 nm) were stable during the first 15 min after birth (DPF: 4.47 (0.38), 4.41 (0.32), and 4.06 (0.28)/cm; μs’: 6.54 (0.67), 5.82 (0.84), and 5.43 (0.95)/cm). Accordingly, we proved that TRS can stably measure cerebral hemodynamics, despite the dramatic physiological changes occurring at this time in the labor room.

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Transitional Changes in Cerebral Blood Volume at Birth

Cited by 109 publications

References 21 publications

Comparison of frequency-domain and continuous-wave near-infrared spectroscopy devices during the immediate transition

Comparison of frequency-domain and continuous-wave near-infrared spectroscopy devices during the immediate transition

Do Sustained Lung Inflations during Neonatal Resuscitation Affect Cerebral Blood Volume in Preterm Infants? A Randomized Controlled Pilot Study

Measurement of the Absolute Value of Cerebral Blood Volume and Optical Properties in Term Neonates Immediately after Birth Using Near-Infrared Time-Resolved Spectroscopy: A Preliminary Observation Study

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