Reference Ranges for Regional Cerebral Tissue Oxygen Saturation and Fractional Oxygen Extraction in Neonates during Immediate Transition after Birth
Reference Ranges for Regional Cerebral Tissue Oxygen Saturation and Fractional Oxygen Extraction in Neonates during Immediate Transition after Birth
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DOI：
10.1016/j.jpeds.2013.07.007
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发表时间：
2013-12-01
影响因子：
5.1
通讯作者：
Urlesberger, Berndt
中科院分区：
文献类型：
--
作者：
Pichler, Gerhard;Binder, Corinna;Urlesberger, Berndt
目的 确定不需要医疗支持的新生儿出生后前 15 分钟内局部脑组织氧饱和度 (crSO(2)) 和局部脑组织氧提取分数 (cFTOE) 的参考范围。 研究设计 使用近红外光谱仪（Invos 5100 脑/体氧监测仪；Somanetics Corp，特洛伊，密歇根州）测量足月和早产新生儿出生后 15 分钟内的 crSO(2)。近红外光谱传感器放置在左额头上。通过脉搏血氧仪连续测量外周血氧饱和度和心率，并计算cFTOE。如果新生儿需要任何医疗支持则被排除。结果 共纳入 381 例新生儿：阴道分娩后足月新生儿 82 例，剖宫产后足月新生儿 272 例，剖宫产后早产儿 27 例。在所有新生儿中，2 分钟时 crSO(2) 中位数（第 10-90 个百分位）为 41% (23-64)，5 分钟时为 68% (45-85)，10 分钟时为 79% (65-90)，15 分钟时为 77% (63-89)。在所有新生儿中，2 分钟时的 cFTOE 中位数（第 10-90 个百分位）为 33% (11-70)，5 分钟时为 21% (6-45)，10 分钟时为 15% (5-31)，15 分钟时为 18% (7-34)。结论 我们报告了在过渡期间无需医疗支持的新生儿的 crSO(2) 和 cFTOE 参考范围出生后。在新生儿过渡期间使用脑氧合监测和使用这些参考范围可能有助于指导氧输送并避免脑氧合不足和氧合过度。
Objective To define reference ranges for regional cerebral tissue oxygen saturation (crSO(2)) and regional cerebral fractional tissue oxygen extraction (cFTOE) during the first 15 minutes after birth in neonates requiring no medical support.Study design The crSO(2) was measured using near infrared spectroscopy (Invos 5100 cerebral/somatic oximeter monitor; Somanetics Corp, Troy, Michigan) during the first 15 minutes after birth for term and preterm neonates. The near infrared spectroscopy sensor was placed on the left forehead. Peripheral oxygen saturation and heart rate were continuously measured by pulse oximetry, and cFTOE was calculated. Neonates were excluded if they required any medical support.Results A total of 381 neonates were included: 82 term neonates after vaginal delivery, 272 term neonates after cesarean delivery, and 27 preterm neonates after cesarean delivery. In all neonates, median (10th-90th percentiles) crSO(2) was 41% (23-64) at 2 minutes, 68% (45-85) at 5 minutes, 79% (65-90) at 10 minutes, and 77% (63-89) at 15 minutes of age. In all neonates, median (10th-90th percentiles) cFTOE was 33% (11-70) at 2 minutes, 21% (6-45) at 5 minutes, 15% (5-31) at 10 minutes, and 18% (7-34) at 15 minutes of age.Conclusion We report reference ranges of crSO(2) and cFTOE in neonates requiring no medical support during transition immediately after birth. The use of cerebral oxygenation monitoring and use of these reference ranges in neonates during transition may help to guide oxygen delivery and avoid cerebral hypo-oxygenation and hyperoxygenation.