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Cerebral haemorrhage in preterm neonates: does cerebral regional oxygen saturation during the immediate transition matter?
  1. Nariae Baik1,2,
  2. Berndt Urlesberger1,2,
  3. Bernhard Schwaberger1,2,
  4. Georg M Schmölzer1,3,4,
  5. Alexander Avian5,
  6. Gerhard Pichler1,2,3,4
  1. 1Division of Neonatology, Department of Paediatrics, Medical University of Graz, Graz, Austria
  2. 2Research Unit for Neonatal Micro- and Macrocirculation, Department of Paediatrics, Medical University of Graz, Graz, Austria
  3. 3Department of Pediatrics, University of Alberta, Edmonton, Canada
  4. 4Centre for the Studies of Asphyxia and Resuscitation, Royal Alexandra Hospital, Edmonton, Canada
  5. 5Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
  1. Correspondence to Dr Gerhard Pichler, Department of Pediatrics, Medical University of Graz, Auenbruggerplatz 34, Graz 8036, Austria; gerhard.pichler{at}medunigraz.at, pichler.gerhard{at}klinikum-graz.at

Abstract

Objectives To investigate the occurrence of peri/intraventricular haemorrhage (P/IVH) in preterm infants and its potential association with cerebral regional oxygen saturation (crSO2) during the immediate transition.

Methods In this two-centre prospective observational cohort study, crSO2 was measured with near-infrared spectroscopy in preterm infants (<32 weeks of gestational age) during the immediate neonatal transition (15 min). In addition, arterial oxygen saturation (SpO2) and heart rate (HR) were monitored with pulse oximetry. Cranial ultrasound scans were performed on day 4, day 7 and day 14 after birth and before discharge. Neonates with IVH of any grade (IVH group) were matched to the neonates without IVH (Non-IVH group) on gestational age (±1 week) and birth weight (±100 g). The duration and magnitude of deviation from the 10th centile in crSO2 during immediate transition was analysed and expressed in %minutes.

Results IVH was found in 12 of the included neonates, who were matched to 12 neonates without IVH. There was no difference in SpO2 and HR between these two groups. The duration and magnitude of centiles-deviation of crSO2 was significantly pronounced in the IVH group compared with the Non-IVH group (1870%min vs 456%min).

Conclusions The neonates of the IVH group showed significantly lower crSO2 values during the immediate transition, although there was no difference concerning SpO2 and HR. The additional monitoring of crSO2 during the immediate transition could reveal neonates with higher risk of developing an IVH later in the course.

  • Neonatology
  • brain injury
  • preterm
  • regional cerebral oxygenation

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