Grizelj Ruža, Ryll Martin J, Bojanić Katarina, Ćaleta Tomislav, Sindičić Dessardo Nada, Vukšić Iva, Schroeder Darrell R, Weingarten Toby N, Radoš Milan, Sprung Juraj
Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia
University of Zagreb School of Medicine, Zagreb, Croatia.
BMJ Paediatr Open. 2025 Jun 3;9(1):e003239. doi: 10.1136/bmjpo-2024-003239.
Reference values of regional cerebral oxygen saturation (rScO) in preterm neonates across gestational age (GA) groups remain undefined. This study aimed to establish rScO references for neonates born before 32 weeks of gestation.
A prospective observational cohort study.
Large tertiary neonatal referral centre in Croatia.
Preterm neonates without major comorbidities born between 2018 and 2022 with normal cranial ultrasound findings.
rScO was assessed with near-infrared spectroscopy (NIRS) using neonatal sensors.
The primary analysis provided rScO reference ranges for the entire preterm neonatal cohort, followed by stratified analyses based on GA: , <28.0 weeks; , 28.0-30.0 weeks; and , 30.1-32.0 weeks. Quantile regression was used to estimate the selected rScO percentiles (5th, 10th, 50th, 90th and 95th) from 6 to 72 hours after birth.
114 neonates with median (IQR) GA of 29.9 (29.1-31.5) weeks were included: 22% were EP, 29% were VP and 49% were VP. The median rScO was 75.6% at 6 hours, 79.5% over the first 24 hours and exceeding 80% in the subsequent 48 hours. When analysed separately, notable differences emerged across prematurity categories, with the highest median rScO observed in the VP group. Supplementary analyses, comparing rScO values across the three GA groups, revealed significant differences at 48 and 72 hours. The majority of the estimated rScO fifth percentiles between 6 and 72 hours were in the range ≥60%, with a single lowest estimate of 56.3% at 6 hours in the EP group. Thus, for all subgroups, the estimated fifth percentile of rScO was above the brain hypoxic threshold.
The use of age-appropriate neonatal NIRS sensors provided the rScO reference values for very and extremely preterm neonates without major comorbidities 6-72 hours after birth.
不同孕周（GA）组的早产儿局部脑氧饱和度（rScO）参考值仍未明确。本研究旨在确定妊娠32周前出生的新生儿的rScO参考值。
一项前瞻性观察性队列研究。
克罗地亚的大型三级新生儿转诊中心。
2018年至2022年间出生、无重大合并症且头颅超声检查结果正常的早产儿。
使用新生儿传感器通过近红外光谱（NIRS）评估rScO。
初步分析提供了整个早产儿队列的rScO参考范围，随后根据GA进行分层分析：<28.0周；28.0 - 30.0周；以及30.1 - 32.0周。采用分位数回归来估计出生后6至72小时选定的rScO百分位数（第5、10、50、90和95百分位数）。
纳入了114例GA中位数（IQR）为29.9（29.1 - 31.5）周的新生儿：22%为极早产儿（EP），29%为早产儿（VP），49%为晚期早产儿（VP）。出生后6小时rScO中位数为75.6%，出生后24小时内为79.5%，随后48小时超过80%。单独分析时，不同早产类别出现了显著差异，VP组观察到的rScO中位数最高。补充分析比较了三个GA组的rScO值，发现在48小时和72小时存在显著差异。出生后6至72小时，大多数估计的rScO第五百分位数在≥60%的范围内，EP组在出生后6小时有一个单一的最低估计值56.3%。因此，对于所有亚组，估计的rScO第五百分位数均高于脑缺氧阈值。
使用适合年龄的新生儿NIRS传感器提供了出生后6至72小时无重大合并症的极早早产儿和早早产儿的rScO参考值。
