出生即刻后新生儿区域性脑组织氧饱和度和氧摄取分数的参考范围。
Reference ranges for regional cerebral tissue oxygen saturation and fractional oxygen extraction in neonates during immediate transition after birth.
机构信息
Research Unit for Cerebral Development and Oximetry, Division of Neonatology, Department of Pediatrics, Medical University of Graz, Graz, Austria.
出版信息
J Pediatr. 2013 Dec;163(6):1558-63. doi: 10.1016/j.jpeds.2013.07.007. Epub 2013 Aug 22.
OBJECTIVE
To define reference ranges for regional cerebral tissue oxygen saturation (crSO2) and regional cerebral fractional tissue oxygen extraction (cFTOE) during the first 15 minutes after birth in neonates requiring no medical support.
STUDY DESIGN
The crSO2 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) crSO2 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 crSO2 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.
目的
确定无医疗支持需求的新生儿出生后 15 分钟内区域性脑组织氧饱和度（crSO2）和区域性脑组织氧摄取分数（cFTOE）的参考范围。
研究设计
使用近红外光谱仪（Invos 5100 脑/躯体血氧计监测仪；Somanetics 公司，密歇根州特洛伊）在足月和早产新生儿出生后 15 分钟内测量 crSO2。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，则将其排除在外。
结果
共纳入 381 例新生儿：82 例经阴道分娩的足月新生儿、272 例剖宫产分娩的足月新生儿和 27 例剖宫产分娩的早产儿。所有新生儿的 crSO2 中位数（10 至 90 百分位数）在 2 分钟时为 41%（23-64），在 5 分钟时为 68%（45-85），在 10 分钟时为 79%（65-90），在 15 分钟时为 77%（63-89）。所有新生儿的 cFTOE 中位数（10 至 90 百分位数）在 2 分钟时为 33%（11-70），在 5 分钟时为 21%（6-45），在 10 分钟时为 15%（5-31），在 15 分钟时为 18%（7-34）。
结论
我们报告了无医疗支持需求的新生儿在出生后过渡期间 crSO2 和 cFTOE 的参考范围。在过渡期间使用脑氧合监测并使用这些参考范围可能有助于指导氧输送，并避免脑缺氧和过度氧合。
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