Schwaberger Bernhard, Pichler Gerhard, Binder Corinna, Avian Alexander, Pocivalnik Mirjam, Urlesberger Berndt
Research Unit for Cerebral Development and Oximetry, Division of Neonatology, Medical University of Graz, Austria. Research Unit for Neonatal Micro- and Macrocirculation, Division of Neonatology, Medical University of Graz, Austria. Division of Neonatology, Department of Paediatrics, Medical University of Graz, Austria.
Physiol Meas. 2014 Oct;35(10):2085-99. doi: 10.1088/0967-3334/35/10/2085. Epub 2014 Sep 22.
Near-infrared spectroscopy (NIRS) enables continuous non-invasive measurements of regional oxygen saturation (rSO2). The aim was to evaluate the dynamics of rSO2 of the brain, preductal and postductal tissues during postnatal transition in preterm infants with and without respiratory support (RS). This single-centre study was designed as an exploratory prospective observational study. Fifty one preterm infants (≥ 30 + 0 and < 37 + 0 weeks) delivered by caesarean section were included. RS using a T-Piece-Resuscitator and supplemental oxygen were given according to guidelines. NIRS measurements were carried out by using Invos Monitor (Covidien; USA) for the first 15 min of life. Three NIRS transducers were attached on the forehead (rSO2brain), the right forearm (rSO2arm) and the left lower leg (rSO2leg). Two groups were compared based on need for RS: normal transition (NT) and RS group.
In NT group rSO2brain increased over time and was significantly higher than rSO2arm, whereas in RS group rSO2brain and rSO2arm increased without significant differences. Courses of rSO2arm and rSO2leg increased over time and showed a converging pattern with initially lower values of rSO2leg in NT group and a diverging pattern with lower levels of rSO2leg in RS group. Overall, rSO2 levels were higher in NT compared to RS group.
Our findings indicate that the decreased rSO2 levels in RS group compared to NT group are not only caused by lower arterial oxygen saturation levels, but also by a compromised perfusion even in infants with only mild respiratory distress.
近红外光谱（NIRS）能够连续无创测量局部氧饱和度（rSO2）。目的是评估有或无呼吸支持（RS）的早产儿出生后过渡期间脑、导管前和导管后组织rSO2的动态变化。这项单中心研究设计为探索性前瞻性观察研究。纳入了51例剖宫产出生的早产儿（≥30 + 0且<37 + 0周）。根据指南给予使用T形复苏器的RS和补充氧气。在出生后的前15分钟使用Invos监护仪（美国科惠力公司）进行NIRS测量。将三个NIRS传感器分别贴在前额（rSO2脑）、右前臂（rSO2臂）和左小腿（rSO2腿）上。根据是否需要RS将两组进行比较：正常过渡（NT）组和RS组。
在NT组中，rSO2脑随时间增加，且显著高于rSO2臂；而在RS组中，rSO2脑和rSO2臂增加但无显著差异。rSO2臂和rSO2腿的变化过程随时间增加，在NT组中呈现出初始rSO2腿值较低的趋同模式，在RS组中呈现出rSO2腿水平较低的发散模式。总体而言，NT组的rSO2水平高于RS组。
我们的研究结果表明，与NT组相比，RS组rSO2水平降低不仅是由于动脉血氧饱和度水平较低，还由于即使是仅有轻度呼吸窘迫的婴儿其灌注也受到损害。
