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出生时脑血容量的过渡性变化。

Transitional Changes in Cerebral Blood Volume at Birth.

作者信息

Schwaberger Bernhard, Pichler Gerhard, Binder-Heschl Corinna, Baik Nariae, Avian Alexander, Urlesberger Berndt

机构信息

Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, Austria.

出版信息

Neonatology. 2015;108(4):253-8. doi: 10.1159/000437347. Epub 2015 Aug 25.

Abstract

BACKGROUND

Near-infrared spectroscopy (NIRS) enables non-invasive measurements of changes in the concentration of oxygenated (x0394;HbO2) and reduced (x0394;HbR) haemoglobin. Changes in total haemoglobin (x0394;HbT = x0394;HbO2 + x0394;HbR) provide information on changes in cerebral blood volume (CBV).

OBJECTIVE

The aim was to evaluate the behaviour of CBV during immediate postnatal transition in term infants.

DESIGN

This observational study was conducted at the Medical University of Graz. NIRS measurements were carried out in term infants without need for respiratory support by using 'NIRO 200-NX' (Hamamatsu) over the first 15 min after birth.

RESULTS

109 infants with a mean gestational age of 38 + 6 weeks (±7 days) and birth weight of 3,242 g (±481) were included. Related to a reference value at minute 15, a significant decrease of HbT was observed for each minute within the study period. The mean (±SD) decrease of HbT of 17 (±40) µmol/l from minutes 2 to 15 represents a decrease of CBV of 1.0 ml/100 g brain (±2.2).

CONCLUSIONS

In healthy newborns, CBV decreased over the whole study period. This likely reflects a physiological process. The impact and clinical relevance of different CBV behaviour during immediate transition needs to be investigated in further studies.

摘要

背景

近红外光谱技术(NIRS)能够对氧合血红蛋白(ΔHbO₂)和还原血红蛋白(ΔHbR)浓度的变化进行无创测量。总血红蛋白的变化(ΔHbT = ΔHbO₂ + ΔHbR)可提供脑血容量(CBV)变化的信息。

目的

评估足月儿出生后即刻过渡期间CBV的变化情况。

设计

本观察性研究在格拉茨医科大学进行。使用“NIRO 200 - NX”(滨松)对出生后前15分钟内无需呼吸支持的足月儿进行NIRS测量。

结果

纳入了109例平均胎龄为38 + 6周(±7天)、出生体重为3242 g(±481)的婴儿。与第15分钟时的参考值相比,在研究期间每分钟均观察到HbT显著下降。从第2分钟到第15分钟,HbT平均(±标准差)下降17(±40)μmol/l,这代表CBV下降1.0 ml/100 g脑(±2.2)。

结论

在健康新生儿中,整个研究期间CBV均下降。这可能反映了一个生理过程。即刻过渡期间不同CBV行为的影响和临床相关性需要在进一步研究中进行探讨。

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