Matyas Melinda, Iancu Mihaela, Hasmasanu Monica, Man Anca, Zaharie Gabriela
Neonatology Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 3, Clinicilor Street, 400012 Cluj-Napoca, Romania.
Department of Medical Informatics and Biostatistics, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, Victor Babes Street, 400012 Cluj-Napoca, Romania.
J Clin Med. 2022 Jun 20;11(12):3546. doi: 10.3390/jcm11123546.
(1) Background: Near-infrared spectroscopy (NIRS) is a non-invasive, easily performed method of monitoring brain oxygenation. The regional cerebral oxygen saturation (crSaO2) and the cerebral fractional tissue oxygen extraction (cFTOE) evaluated by NIRS provide more accurate information on brain oxygenation than the blood oxygen saturation. We investigated the effect of perinatal factors on cerebral oxygenation of preterm newborns. (2) Methods: We conducted a longitudinal study with 48 preterm newborns <34 weeks of gestation who underwent NIRS registration during the first 72 h of life. crSaO2 was measured and cFTOE was calculated foreach patient. (3) Results: One-way ANOVA showed no significant main effect of IVH severity on crSaO2 and cFTOE (p > 0.05); there was a tendency toward statistical significance concerning the difference between the means of crSaO2 (p = 0.083) and cFTOE (p = 0.098). Patients with intraventricular haemorrhage (IVH) had a lower mean of crSaO2 and a higher mean of cFTOE (59.67 ± 10.37% vs. 64.92 ± 10.16% for crSaO2; 0.37 ± 0.11 vs. 0.32 ± 0.11 for cFTOE) compared to those with no IVH. Significantly lower values of crSaO2 and higher values of cFTOE were found in neonates receiving inotropic treatment (p < 0.0001). Episodes of apnoea also proved to influence the cerebral oxygen saturation of the study group (p = 0.0026). No significant association between the maternal hypertension treatment and the cerebral oxygenation of preterms was found. (4) Conclusions: This study showed a decreased cerebral oxygen saturation of preterms with IVH, inotrope support and apnoea episodes.
(1) 背景:近红外光谱技术(NIRS)是一种用于监测脑氧合的非侵入性且操作简便的方法。通过NIRS评估的局部脑氧饱和度(crSaO2)和脑部分组织氧摄取率(cFTOE)比血氧饱和度能提供更准确的脑氧合信息。我们研究了围产期因素对早产新生儿脑氧合的影响。(2) 方法:我们对48例孕周<34周的早产新生儿进行了一项纵向研究,这些新生儿在出生后的头72小时内接受了NIRS检测。测量了每个患者的crSaO2并计算了cFTOE。(3) 结果:单因素方差分析显示,IVH严重程度对crSaO2和cFTOE无显著主效应(p>0.05);crSaO2均值(p = 0.083)和cFTOE均值(p = 0.098)之间的差异有统计学意义的趋势。与无IVH的患者相比,患有脑室内出血(IVH)的患者crSaO2均值较低,cFTOE均值较高(crSaO2分别为59.67±10.37%和64.92±10.16%;cFTOE分别为0.37±0.11和0.32±0.11)。接受强心治疗的新生儿crSaO2值显著较低,cFTOE值较高(p<0.0001)。呼吸暂停发作也被证明会影响研究组的脑氧饱和度(p = 0.0026)。未发现母亲高血压治疗与早产新生儿脑氧合之间存在显著关联。(4) 结论:本研究表明,患有IVH、接受强心支持治疗和出现呼吸暂停发作的早产新生儿脑氧饱和度降低。