Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation?

• Main Authors: Corinna Binder-Heschl (Author), Gerhard Pichler (Author), Alexander Avian (Author), Bernhard Schwaberger (Author), Nariae Baik-Schneditz (Author), Lukas Mileder (Author), Stefan Heschl (Author), Berndt Urlesberger (Author)
• Format: Book
• Published: Frontiers Media S.A., 2019-07-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2360; 10.3389/fped.2019.00274
• Keywords: near infrared spectroscopy; regional cerebral oxygenation; respiratory support; transition period; preterm neonates; arterial oxygen saturation; Pediatrics; RJ1-570
• Source: Frontiers in Pediatrics, Vol 7 (2019)

Objective: To investigate if preterm neonates with arterial oxygen saturation (SpO2)<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO2), compared to infants reaching the target.Methods: Retrospective analysis of four prospective observational studies. Preterm neonates needing respiratory support during delivery room stabilization were included. Regional cerebral tissue oxygen saturation was measured with near-infrared spectroscopy (NIRS) during the first 15 min after birth along with SpO2 and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO2 ≥ 80% ("≥80% group") and those with a 5-min SpO2 < 80% ("<80% group"). Groups were compared regarding rcStO2, SpO2, and HR. Furthermore, we analyzed whether a 5-min SpO2 < 80% was associated with a rcStO2 below the 10th percentile at the same time point.Results: 146 neonates were included, with 68 (47%) in the "≥80% group" and 78 (53%) in the "<80% group." Neonates in the " <80% group" had a significantly lower rcStO2 (p < 0.001). Furthermore, 80.3% of neonates in the " <80% group" and 23.4% in the "≥80% group" had rcStO2 values below the 10th percentile at 5 min (p < 0.001). HR was significantly lower at minute 3 and 4 in the " <80% group" (p < 0.002).Conclusion: Preterm infants needing respiratory support, who do not reach the SpO2 target of 80% at 5 min after birth, show significantly diminished rcStO2 values compared to neonates reaching the target.