脑组织氧饱和度与早产儿出生第一天的N末端脑钠肽前体有关。

Cerebral tissue oxygen saturation is associated with N-terminal probrain natriuretic peptide in preterm infants on their first day of life.

作者信息

Binder-Heschl Corinna, Urlesberger Berndt, Koestenberger Martin, Schwaberger Bernhard, Schmölzer Georg M, Pichler Gerhard

机构信息

Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria; Research Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, Austria; Division of Neonatology, Department of Pediatrics, Medical University, Graz, Austria.

出版信息

Acta Paediatr. 2015 Jan;104(1):32-7. doi: 10.1111/apa.12828. Epub 2014 Nov 16.

DOI:10.1111/apa.12828

PMID:25319883

Abstract

AIM

This prospective observational study investigated if N-terminal probrain natriuretic peptide (NT-proBNP), a cardiac biomarker, correlated with cerebral tissue oxygen saturation (crSO2) in preterm infants on their first day of life.

METHODS

Using near infrared spectroscopy (NIRS), crSO2 was measured on the right forehead of preterm infants for 24 h. We also recorded arterial oxygen saturation (SpO2 ) and calculated fractional tissue oxygen extraction (cFTOE) values. At the end of the NIRS measurement, blood was taken to analyse NT-proBNP. Mean values for the 24-h period were calculated for crSO2 , cFTOE, SpO2 and these values were correlated to NT-proBNP. An echocardiography was performed in all infants during the measurement period.

RESULTS

We analysed 35 preterm neonates (33 ± 2 weeks, 1965 ± 523 g). NIRS measurements started at 3 ± 1 h and blood samples were taken at 24 ± 5 h postnatal. Echocardiography showed an open ductus arteriosus in all infants. Mean NT-proBNP was 4978 ± 3566 pg/mL, crSO2 was 76 ± 8%, and cFTOE was 0.20 ± 0.08. NT-proBNP correlated negatively with crSO2 (r = -0.75; p ≤ 0.001) and positively with cFTOE (r = 0.731; p ≤ 0.001).

CONCLUSION

These results emphasise that crSO2 is influenced by cardiac function, in addition to oxygen consumption, arterial oxygen saturation and vascular resistance, and this can be measured by NT-proBNP.

摘要

目的

本前瞻性观察性研究调查了心脏生物标志物N末端脑钠肽前体（NT-proBNP）与早产儿出生第一天的脑组织氧饱和度（crSO2）是否相关。

方法

使用近红外光谱（NIRS）对早产儿右前额进行24小时的crSO2测量。我们还记录了动脉血氧饱和度（SpO2）并计算了组织氧摄取分数（cFTOE）值。在NIRS测量结束时，采集血液分析NT-proBNP。计算crSO2、cFTOE、SpO2的24小时平均值，并将这些值与NT-proBNP进行相关性分析。在测量期间对所有婴儿进行了超声心动图检查。

结果

我们分析了35例早产儿（33±2周，1965±523克）。NIRS测量在出生后3±1小时开始，血样在出生后24±5小时采集。超声心动图显示所有婴儿动脉导管未闭。NT-proBNP的平均水平为4978±3566 pg/mL，crSO2为76±8%，cFTOE为0.20±0.08。NT-proBNP与crSO2呈负相关（r = -0.75；p≤0.001），与cFTOE呈正相关（r = 0.731；p≤0.001）。