Kenosi M, O'Toole J M, Hawkes G A, Hutch W, Low E, Wall M, Boylan G B, Ryan C A, Dempsey E M
Department of Paediatrics and Child Health, Neonatal Intensive Care Unit, Wilton, Cork, Ireland.
INFANT, Irish Centre for Fetal and Neonatal Translational research, University College Cork, Cork, Ireland.
J Perinatol. 2018 Mar;38(3):264-270. doi: 10.1038/s41372-017-0007-5. Epub 2017 Dec 15.
Cerebral oxygenation (rcSO) monitoring in preterm infants may identify periods of cerebral hypoxia or hyperoxia. We hypothesised that there was a relationship between rcSO values and short term outcome in infants of GA < 32weeks.
RcSO values were recorded for the first 48 h of life using an INVOS monitor with a neonatal sensor. The association between cranial ultrasound scan measured brain injury and rcSO was assessed.
120 infants were included. Sixty-nine percent (83) of infants had a normal outcome (no IVH, no PVL, and survival at 1 month); less than one-quarter, 22% (26), had low grade IVH 1 or 2 (moderate outcome); and 9% (11) of infants had a severe outcome (IVH ≥ 3, PVL or died before 1 month age). rcSO values were lower for infants GA < 28weeks when compared with those GA 28-32, p < 0.001. There was no difference in absolute rcSO values between the three outcome groups but a greater degree of cerebral hypoxia was associated with preterm infants who had low grade 1 or 2 IVH.
Infants of GA < 28 weeks have lower cerebral oxygenation in the first 2 days of life. A greater degree of hypoxia was seen in infants with grade 1 or 2 haemorrhage. Normative ranges need to be gestation specific.
对早产儿进行脑氧合（rcSO）监测可识别脑缺氧或高氧期。我们假设rcSO值与孕龄小于32周婴儿的短期预后之间存在关联。
使用带有新生儿传感器的INVOS监测仪记录出生后48小时内的rcSO值。评估经头颅超声扫描测量的脑损伤与rcSO之间的关联。
纳入120例婴儿。69%（83例）婴儿预后正常（无脑室内出血、无脑室周围白质软化，且1个月时存活）；不到四分之一，即22%（26例）有1级或2级轻度脑室内出血（中度预后）；9%（11例）婴儿预后严重（脑室内出血≥3级、脑室周围白质软化或1个月龄前死亡）。与孕龄28 - 32周的婴儿相比，孕龄小于28周的婴儿rcSO值更低，p < 0.001。三个预后组之间的绝对rcSO值无差异，但1级或2级轻度脑室内出血的早产儿存在更严重的脑缺氧。
孕龄小于28周的婴儿在出生后前两天脑氧合较低。1级或2级出血的婴儿脑缺氧程度更严重。正常范围需要根据孕周确定。
