ОЦЕНКА ЦЕРЕБРАЛЬНОЙ ОКСИГЕНАЦИИ ПРИ РАЗВИТИИ ТРАНЗИТОРНОГО ТАХИПНОЭ У НОВОРОЖДЕННЫХ

Abstract

One of the most common respiratory diseases in term and late preterm infants is the Transient tachypnea of the newborn (TTN). The clinical picture of TTN is characterized by respiratory disorders with the development of hypoxemia, which is especially important for the functioning of the central nervous system and may cause its damage. One of the methods for functional assessment of the supply of oxygen to the brain is the determination of cerebral oxygenation (CO) using the Near-infrared spectroscopy (NIRS). The purpose of this research was to assess the CO in TTN using the NIRS technology. Materials and methods used: a single-center prospective cohort study was conducted from June 01 till Dec. 31, 2021. The study group consisted of 75 full-term newborns with the development of a clinical picture of TTN and a Downes score of ≥3 pts within 60 minutes after birth. Exclusion criteria: other causes of respiratory disorders. The control group consisted of 20 full-term healthy newborns after the C-section recruited by continuous sampling within 3 days from Dec. 21 to 23, 2021. The study of CO was performed only at the stage of the delivery room using the SenSmart™ Model X-100 device; the single-channel monitoring was performed with an SenSmart™ 8004CB-NA sensor (both - by Nonin Medical, Inc., USA). Results: based on the results of the analysis of the data obtained, an increase in the CO indicators in the study group was demonstrated from 72% at the 10th minute to 81% at the 60th minute of life with a further decrease to 80% to 79%. In contrast to healthy newborns, who’ve also showed an increase in CO from 75% at the 5th minute, and reaching a plateau level of 80% already at the 15th minute with a further decrease in indicators to 79% to 77%, a statistically significant difference between the groups was found at the 10th minute with a higher CO level in the group of healthy children (79 (78-82)% vs. 72 (70-73)%, p=0.007). Despite the fact that there was no statistically significant correlation between the severity of respiratory disorders, the development of cerebral ischemia and the CO indicators, there is a general trend towards a decrease and a slow increase in the CO level in full-term patients with TTN. Conclusion: the study showed that in the process of developing TTN, not only the respiratory function suffers, but also the processes of oxygenation of the brain. A prolonged period of low CO levels may have adverse outcomes for the CNS, the life and health of the child in general, this therefore requires further research.