Research Unit for Cerebral Development and Oximetry, Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
J Pediatr. 2010 Nov;157(5):740-4. doi: 10.1016/j.jpeds.2010.05.013. Epub 2010 Jun 17.
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.
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.
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.
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.
评估出生后即刻过渡期间脑和动脉导管前及动脉导管后外周（肌肉）组织的局部组织氧合，并与外周动脉导管前及动脉导管后血氧饱和度相关联。
我们进行了一项前瞻性观察性研究。通过近红外光谱（NIRS），在 59 名择期剖宫产的健康足月婴儿出生后的头 10 分钟内，测量脑（rSO2brain）、动脉导管前外周组织（rSO2pre）和动脉导管后外周组织（rSO2post）的局部氧饱和度（rSO2brain）变化。计算了所有 3 个区域的局部组织氧摄取分数。
脑的平均 rSO2brain 从 44%（3 分钟）迅速增加到 76%（7 分钟）；此后无显著变化。平均 rSO2pre 和 rSO2post 从第 3 分钟到第 10 分钟持续增加，从 36%（pre）/27%（post）增加到 66%（pre）/58%（post）。在生命的最初几分钟内，所有 3 个区域的局部组织氧摄取分数均下降。5 分钟后，脑的局部组织氧摄取分数无明显变化，8 分钟后，动脉导管前和动脉导管后的局部组织氧摄取分数无明显变化。
在过渡期间，大脑的饱和度最高，表明氧气输送到大脑的偏好。与外周组织相比，脑的局部组织氧摄取分数更早达到平台期。
