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
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DOI：
10.1159/000438450
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发表时间：
2015-01-01
期刊：
影响因子：
2.5
通讯作者：
Pichler, Gerhard
中科院分区：
文献类型：
--
作者：
Baik, Nariae;Urlesberger, Berndt;Pichler, Gerhard
背景：使用近红外光谱（NIRS）对出生后立即过渡时期的大脑进行无创监测越来越受到关注。目的：本研究的目的是确定在没有任何医疗支持的早产儿和足月新生儿出生后最初15分钟内，使用NIRO 200NX （NIRO, Hamamatsu, Japan）和脑组织分数氧提取（cFTOE）测量区域脑组织氧合指数（cTOI）的参考范围和百分位图。方法：采用NIRO 200NX测量早产、足月儿剖宫产后15 min的cTOI。nirs传感器放置在右前额。脉搏血氧仪连续测量外周动脉血氧饱和度（SpO(2)）和心率。cFTOE由cTOI和SpO计算得出(2)。需要任何医疗支持的新生儿被排除在外。结果：共纳入新生儿230例，排除90例。因此，纳入140个足月新生儿，并使用数据定义参考范围和百分位图。出生后第50百分位（10 ~ 90百分位）的cTOI在出生后2分钟为56%(39 ~ 75)，5分钟为66%(50 ~ 78)，10分钟为75%(62 ~ 85)，15分钟为73%（61 ~ 84）。第50百分位cFTOE在出生后2分钟为0.24(0.11-0.44)，5分钟为0.20(0.10-0.35)，10分钟为0.21(0.09-0.35)，15分钟为0.24（0.13-0.37）。结论：本观察性研究增加了NIRO 200NX测量cTOI的参考范围和百分位图，以及由新生儿过渡期cTOI和SpO(2)计算的cFTOE。由于INVOS 5100C测量的cTOI和脑区域组织氧饱和度之间的差异随着区域氧合的增加而变化，因此每种仪器的百分位数对于未来的临床应用是必要的。(C) 2015 S. Karger AG，巴塞尔
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 (SpO(2)) and heart rate were continuously measured by pulse oximetry. cFTOE was calculated out of cTOI and SpO(2). 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 SpO(2) 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. (C) 2015 S. Karger AG, Basel