Bruckner Marlies, Mileder Lukas P, Richter Alisa, Baik-Schneditz Nariae, Schwaberger Bernhard, Binder-Heschl Corinna, Urlesberger Berndt, Pichler Gerhard
Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, 8036 Graz, Austria.
Children (Basel). 2020 Oct 29;7(11):205. doi: 10.3390/children7110205.
Body temperature (BT) management remains a challenge in neonatal intensive care, especially during resuscitation after birth. Our aim is to analyze whether there is an association between the BT and cerebral and peripheral tissue oxygen saturation (crSO/cTOI and prSO), arterial oxygen saturation (SpO), and heart rate (HR). The secondary outcome parameters of five prospective observational studies are analyzed. We include preterm and term neonates born by Caesarean section who received continuous pulse oximetry and near-infrared spectroscopy monitoring during the first 15 min, and a rectal BT measurement once in minute 15 after birth. Four-hundred seventeen term and 169 preterm neonates are included. The BT did not correlate with crSO/cTOI and SpO. The BT correlated with the HR in all neonates (ρ = 0.210, < 0.001) and with prSO only in preterm neonates (ρ = -0.285, = 0.020). The BT was lower in preterm compared to term infants (36.7 [36.4-37.0] vs. 36.8 [36.6-37.0], = 0.001) and prevalence of hypothermia was higher in preterm neonates (29.5% vs. 12.0%, < 0.001). To conclude, the BT did not correlate with SpO and crSO/cTOI, however, there was a weak positive correlation between the BT and the HR in the whole cohort and a weak correlation between the BT and prSO only in preterm infants. Preterm neonates had a statistically lower BT and suffered significantly more often from hypothermia during postnatal transition.
体温（BT）管理在新生儿重症监护中仍然是一项挑战，尤其是在出生后的复苏过程中。我们的目的是分析BT与脑和外周组织氧饱和度（crSO/cTOI和prSO）、动脉血氧饱和度（SpO）以及心率（HR）之间是否存在关联。对五项前瞻性观察性研究的次要结局参数进行分析。我们纳入了剖宫产出生的早产儿和足月儿，他们在出生后的前15分钟接受连续脉搏血氧饱和度和近红外光谱监测，并在出生后第15分钟测量一次直肠BT。共纳入417名足月儿和169名早产儿。BT与crSO/cTOI和SpO无相关性。BT与所有新生儿的HR相关（ρ = 0.210，<0.001），仅与早产儿的prSO相关（ρ = -0.285，= 0.020）。与足月儿相比，早产儿的BT较低（36.7 [36.4 - 37.0] vs. 36.8 [36.6 - 37.0]，= 0.001），早产儿低体温的发生率更高（29.5% vs. 12.0%，<0.001）。总之，BT与SpO和crSO/cTOI无相关性，然而，在整个队列中BT与HR之间存在弱正相关，仅在早产儿中BT与prSO之间存在弱相关。早产儿的BT在统计学上较低，并且在出生后过渡期发生低体温的频率明显更高。
