Pediatric Department, Peking University First Hospital, Beijing, China.
Pediatric Department, Tibet Autonomous Region People's Hospital, Lhasa, China.
Neonatology. 2021;118(3):348-353. doi: 10.1159/000514403. Epub 2021 Jun 9.
Accurate detection of cerebral oxygen saturation (rSO2) may be useful for neonatal brain injury prevention, and the normal range of rSO2 of neonates at high altitude remained unclear.
To compare cerebral rSO2 and cerebral fractional tissue oxygen extraction (cFTOE) at high-altitude and low-altitude areas in healthy neonates and neonates with underlying diseases.
515 neonates from low-altitude areas and 151 from Tibet were enrolled. These neonates were assigned into the normal group, hypoxic-ischemic encephalopathy (HIE) group, and other diseases group. Near-infrared spectroscopy was used to measure rSO2 in neonates within 24 h after admission. The differences of rSO2, pulse oxygen saturation (SpO2), and cFTOE levels were compared between neonates from low- and high-altitude areas.
(1) The mean rSO2 and cFTOE levels in normal neonates from Tibet were 55.0 ± 6.4% and 32.6 ± 8.5%, significantly lower than those from low-altitude areas (p < 0.05). (2) At high altitude, neonates with HIE, pneumonia (p < 0.05), anemia, and congenital heart disease (p < 0.05) have higher cFTOE than healthy neonates. (3) Compared with HIE neonates from plain areas, neonates with HIE at higher altitude had lower cFTOE (p < 0.05), while neonates with heart disease in plateau areas had higher cFTOE than those in plain areas (p < 0.05).
The rSO2 and cFTOE levels in normal neonates from high-altitude areas are lower than neonates from the low-altitude areas. Lower cFTOE is possibly because of an increase in blood flow to the brain, and this may be adversely affected by disease states which may increase the risk of brain injury.
准确检测脑氧饱和度（rSO2）可能有助于预防新生儿脑损伤，而高海拔地区正常新生儿的 rSO2 范围尚不清楚。
比较高海拔和低海拔地区健康新生儿和患有基础疾病的新生儿的脑 rSO2 和脑局部组织氧摄取分数（cFTOE）。
纳入来自低海拔地区的 515 例新生儿和来自西藏的 151 例新生儿。这些新生儿被分为正常组、缺氧缺血性脑病（HIE）组和其他疾病组。入院后 24 小时内使用近红外光谱仪测量新生儿的 rSO2。比较高海拔和低海拔地区新生儿 rSO2、脉搏血氧饱和度（SpO2）和 cFTOE 水平的差异。
（1）来自西藏的正常新生儿的平均 rSO2 和 cFTOE 水平分别为 55.0±6.4%和 32.6±8.5%，显著低于低海拔地区的新生儿（p<0.05）。（2）在高海拔地区，患有 HIE、肺炎（p<0.05）、贫血和先天性心脏病的新生儿的 cFTOE 高于健康新生儿。（3）与平原地区的 HIE 新生儿相比，高海拔地区的 HIE 新生儿的 cFTOE 较低（p<0.05），而高原地区心脏病新生儿的 cFTOE 高于平原地区（p<0.05）。
高海拔地区正常新生儿的 rSO2 和 cFTOE 水平低于低海拔地区新生儿。较低的 cFTOE 可能是由于脑血流量增加所致，而疾病状态可能会增加脑损伤的风险，从而对其产生不利影响。
