Regional Oxygen Saturation of the Brain and Peripheral Tissue during Birth Transition of Term Infants
Regional Oxygen Saturation of the Brain and Peripheral Tissue during Birth Transition of Term Infants
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DOI：
10.1016/j.jpeds.2010.05.013
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发表时间：
2010-11-01
影响因子：
5.1
通讯作者：
Pichler, Gerhard
中科院分区：
文献类型：
--
作者：
Urlesberger, Berndt;Grossauer, Karin;Pichler, Gerhard
目的探讨新生儿出生后立即过渡期脑及导管前、导管后外周（肌肉）组织的局部氧合情况，并与外周导管前、导管后动脉氧饱和度的关系。研究设计我们进行了一项前瞻性观察性研究。采用近红外光谱（NIRS）技术测定59例健康足月婴儿择期剖宫产后出生后10分钟内脑（rSO2brain）、外周导管组织（rSO2pre）和外周导管后组织（rSO2post）的区域氧饱和度变化。计算所有3个区域的组织氧萃取分数。结果rSO2brain均值由44%（3分钟）迅速上升至76%（7分钟）；此后没有发生重大变化。平均rSO2pre和rSO2post从第3分钟到第10分钟不断增加，从36%（前）/27%（后）到66%（前）/58%（后）。在生命的最初几分钟内，所有3个区域的组织氧提取分数都有所下降。脑组织分数组织氧提取在5分钟后无明显变化，导管前和导管后分数组织氧提取在8分钟后无显著变化。在过渡阶段，大脑具有最高的饱和水平，表明优先向大脑输送氧气。与外周组织相比，脑组织部分组织氧提取较早达到平台期。[J] .中华儿科杂志，2010;57:74 - 74。
Objective To evaluate regional tissue oxygenation of the brain and preductal and postductal peripheral (muscle) tissue during immediate transition after birth, and to correlate with peripheral preductal and postductal arterial oxygen saturation.Study design We conducted a prospective observational study. With near-infrared spectroscopy (NIRS), changes in regional oxygen saturation of the brain (rSO2brain), peripheral preductal tissue (rSO2pre), and peripheral postductal tissue (rSO2post) were measured during the first 10 minutes of life in 59 healthy term infants after elective caesarean delivery. Fractional tissue oxygen extraction was calculated for all 3 regions.Results Mean rSO2brain increased rapidly from 44% (3 minutes) to 76% (7 minutes); thereafter no significant change occurred. Mean rSO2pre and rSO2post increased constantly from minute 3 to minute 10, from 36%(pre)/27%(post) to 66%(pre)/58%(post). Fractional tissue oxygen extraction decreased in all 3 regions during the first minutes of life. Fractional tissue oxygen extraction of the brain did not change significantly after 5 minutes, and preductal and postductal fractional tissue oxygen extraction did not change significantly after 8 minutes.Conclusions During transition, the brain had the highest saturation levels, indicating a preference of oxygen delivery to the brain. Fractional tissue oxygen extraction of the brain reached a plateau earlier compared with peripheral tissue. (J Pediatr 2010; 157:740-4).