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

Fauchère, Jean-Claude; Schulz, Gabriele; Haensse, Daniel; Keller, Esther; Ersch, Jörg; Bucher, Hans Ulrich; Wolf, Martin

doi:10.1016/j.jpeds.2009.09.050

« Previous Next »The Journal of Pediatrics
Volume 156, Issue 3 , Pages 372-376, March 2010

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

Jean-Claude Fauchère, MD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland
- Reprint requests: Jean-Claude Fauchère, MD, Neonatology Clinic, Perinatal Center, Department of Obstetrics & Gynecology, University Hospital, Frauenklinikstrasse 10, CH-8091 Zurich, Switzerland.
Gabriele Schulz, MD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland
Daniel Haensse, PhD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland
Esther Keller, MD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland
- University of Utrecht and Wilhelmina Children's Hospital, Utrecht, The Netherlands
Jörg Ersch, MD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland
Hans Ulrich Bucher, MD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland
Martin Wolf, PhD
- Department Obstetrics & Gynecology, Clinic of Neonatology, University Hospital Zurich, Zurich, Switzerland

Received 21 January 2009; received in revised form 16 June 2009; accepted 21 September 2009. published online 16 November 2009.

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 (O₂Hb), 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

O₂Hb and TOI increased rapidly within the first minutes of life (median slope for O₂Hb, 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). O₂Hb, TOI, and HHb all reached a plateau within 8 minutes.

Conclusions

A significant increase in cerebral O₂Hb 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.

AV, Arteriovenous, FiO₂, Fraction of inspired oxygen, FTOE, Fractional cerebral tissue oxygen extraction, HHb, Deoxygenated hemoglobin, HR, Heart rate, NIRS, Near-infrared spectroscopy, O₂Hb, Oxygenated hemoglobin, SpO₂, Peripheral arterial oxygen saturation, THI, Tissue hemoglobin index, TOI, Tissue oxygenation index