Near-Infrared Spectroscopy Measurements of Cerebral Oxygenation in Newborns during Immediate Postnatal Adaptation

• Published in: The Journal of pediatrics Vol. 156; no. 3; pp. 372 - 376
• Main Authors: Fauchère, Jean-Claude, MD, Schulz, Gabriele, MD, Haensse, Daniel, PhD, Keller, Esther, MD, Ersch, Jörg, MD, Bucher, Hans Ulrich, MD, Wolf, Martin, PhD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.03.2010; Elsevier
• Subjects: Adaptation, Physiological; Biological and medical sciences; Brain - metabolism; Cerebrovascular Circulation; Female; General aspects; Hemoglobins - analysis; Humans; Infant, Newborn - metabolism; Male; Medical sciences; Oxygen - metabolism; Pediatrics; Spectroscopy, Near-Infrared; SpO 2; HHb; FTOE; Deoxygenated hemoglobin; Arteriovenous; HR; Peripheral arterial oxygen saturation; Tissue hemoglobin index; Near-infrared spectroscopy; TOI; Fraction of inspired oxygen; Heart rate; O 2Hb; Oxygenated hemoglobin; THI; AV; FiO 2; NIRS; Tissue oxygenation index; Fractional cerebral tissue oxygen extraction; Human; Measurement; Pediatrics; Near infrared spectrometry; Newborn; Postnatal; Central nervous system; Oxygenation; Adaptation; Encephalon
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2009.09.050

Objective In view of growing concerns regarding the optimal supplementation of oxygen at birth, we measured cerebral oxygenation during the first minutes of life. Study design Using near-infrared spectroscopy, changes in cerebral oxygenated hemoglobin (O2 Hb), dexoxygenated hemoglobin (HHb), and tissue oxygenation index (TOI) were measured during the first 15 minutes of life in 20 healthy newborn infants delivered at term by elective cesarean section. Results O2 Hb and TOI increased rapidly within the first minutes of life (median slope for O2 Hb, 3.4 μmol/L/min; range, 1.4 to 20.6 μmol/L/min; median slope for TOI, 4.2 %/min; range, -0.4 to 27.3%/min), and cerebral HHb decreased (median slope, -4.8 μmol/L/min; range, -0.2 to -20.6 μmol/L/min). O2 Hb, TOI, and HHb all reached a plateau within 8 minutes. Conclusions A significant increase in cerebral O2 Hb and TOI and a significant decrease in HHb occur during immediate adaptation in healthy term newborns, reaching a steady plateau at around 8 minutes after birth.