Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.
Acta Paediatr. 2023 Jul;112(7):1404-1412. doi: 10.1111/apa.16745. Epub 2023 Mar 14.
To examine potential correlations between cardiac output (CO) with cerebral-regional-oxygen-saturation (crSO ) and cerebral-fractional-tissue-oxygen-extraction (cFTOE) during immediate foetal-to-neonatal transition in term and preterm neonates with and without respiratory support.
Post hoc analyses of secondary outcome parameters of prospective observational studies were performed. We included neonates with cerebral near-infrared-spectroscopy (NIRS) monitoring and an oscillometric blood pressure measurement at minute 15 after birth. Heart rate (HR) and arterial oxygen saturation (SpO ) were monitored. CO was calculated with Liljestrand and Zander formula and correlated with crSO and cFTOE.
Seventy-nine preterm neonates and 207 term neonates with NIRS measurements and calculated CO were included. In 59 preterm neonates (mean gestational age (GA): 29.4 ± 3.7 weeks) with respiratory support, CO correlated significantly positively with crSO and significantly negatively with cFTOE. In 20 preterm neonates (GA 34.9 ± 1.3 weeks) without respiratory support and in 207 term neonates with and without respiratory support, CO correlated neither with crSO nor with cFTOE.
In compromised preterm neonates with lower gestational age and in need of respiratory support, CO was associated with crSO and cFTOE, whereas in stable preterm neonates with higher gestational age as well as in term neonates with and without respiratory support, no associations were observed.
探讨有创与无创呼吸支持的足月与早产新生儿在即刻胎-新生儿过渡期心输出量（CO）与脑区域性氧饱和度（crSO ）和脑局部组织氧摄取分数（cFTOE）之间的潜在相关性。
对前瞻性观察性研究的次要结局参数进行了事后分析。我们纳入了在出生后 15 分钟内接受近红外光谱（NIRS）监测和振荡血压测量的新生儿。监测心率（HR）和动脉血氧饱和度（SpO ）。使用 Liljestrand 和 Zander 公式计算 CO，并与 crSO 和 cFTOE 进行相关性分析。
共纳入 79 例有 NIRS 测量和计算 CO 的早产儿和 207 例有 NIRS 测量和计算 CO 的足月儿。在 59 例有呼吸支持的早产儿（平均胎龄（GA）：29.4±3.7 周）中，CO 与 crSO 呈显著正相关，与 cFTOE 呈显著负相关。在 20 例无呼吸支持的 GA 为 34.9±1.3 周的早产儿和 207 例有或无呼吸支持的足月儿中，CO 与 crSO 或 cFTOE 均无相关性。
在胎龄较小且需要呼吸支持的有创呼吸支持的危重新生儿中，CO 与 crSO 和 cFTOE 相关，而在胎龄较大且有创或无创呼吸支持的稳定早产儿以及足月儿中，未观察到相关性。
