RT Journal Article
SR Electronic
T1 Cerebral oxygenation and blood flow in term infants during postnatal transition: BabyLux project
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP F648
OP F653
DO 10.1136/archdischild-2018-316400
VO 104
IS 6
A1 Agnese De Carli
A1 Björn Andresen
A1 Martina Giovannella
A1 Turgut Durduran
A1 Davide Contini
A1 Lorenzo Spinelli
A1 Udo Michael Weigel
A1 Sofia Passera
A1 Nicola Pesenti
A1 Fabio Mosca
A1 Alessandro Torricelli
A1 Monica Fumagalli
A1 Gorm Greisen
YR 2019
UL http://fn.bmj.com/content/104/6/F648.abstract
AB Objectives A new device that combines, for the first time, two photonic technologies (time-resolved near-infrared spectroscopy and diffuse correlation spectroscopy) was provided and tested within the BabyLux project. Aim was to validate the expected changes in cerebral oxygenation and blood flow.Methods A pulse oximeter and the BabyLux device were held in place (right hand/wrist and frontoparietal region, respectively) for 10 min after birth in healthy term infants delivered by elective caesarean section. Pulse oximeter saturation (SpO2), cerebral tissue oxygen saturation (StO2) and blood flow index (BFI) were measured over time. Tissue oxygen extraction (TOE) and cerebral metabolic rate of oxygen index (CMRO2I) were calculated.Results Thirty infants were enrolled in two centres. After validity check of data, 23% of infants were excluded from TOE and CMRO2I calculation due to missing data. As expected, SpO2 (estimate 3.05 %/min; 95% CI 2.78 to 3.31 %/min) and StO2 (estimate 3.95 %/min; 95% CI 3.63 to 4.27 %/min) increased in the first 10 min after birth, whereas BFI (estimate −2.84×10−9 cm2/s/min; 95% CI −2.50×10−9 to −3.24×10−9 cm2/s/min) and TOE (estimate −0.78 %/min; 95% CI −1.12 to –0.45 %/min) decreased. Surprisingly, CMRO2I decreased (estimate −7.94×10−8/min; 95% CI −6.26×10−8 to −9.62×10−8/min).Conclusions Brain oxygenation and BFI during transition were successfully and simultaneously obtained by the BabyLux device; no adverse effects were recorded, and the BabyLux device did not limit the standard care. The preliminary results from clinical application of the BabyLux device are encouraging in terms of safety and feasibility; they are consistent with previous reports on brain oxygenation during transition, although the interpretation of the decreasing CMRO2I remains open.Trial registration number NCT02815618.