Cardiac output and regional-cerebral-oxygen-saturation in preterm neonates during immediate postnatal transition - an observational study.

Abstract

To examine potential correlations between cardiac output (CO) with cerebral-regional-oxygen-saturation (crSO2 ) and cerebral-fractional-tissue-oxygen-extraction (cFTOE) during immediate fetal-to-neonatal transition in term and preterm neonates with and without respiratory support. Post-hoc analyses of secondary outcome parameters of prospective observational studies were performed. We included neonates with cerebral near-infrared-spectroscopy (NIRS) monitoring and an oscillometric blood pressure measurement at minute 15 after birth. Heart rate (HR) and arterial oxygen saturation (SpO2 ) were monitored. CO was calculated with Liljestrand and Zander formula and correlated with crSO2 and cFTOE. Seventy-nine preterm neonates and 207 term neonates with NIRS measurements and calculated CO were included. In 59 preterm neonates (mean gestational age (GA): 29.4±3.7 weeks) with respiratory support CO correlated significantly positively with crSO2 and significantly negatively with cFTOE. In 20 preterm neonates (GA 34.9±1.3 weeks) without respiratory support and in 207 term neonates with and without respiratory support CO correlated neither with crSO2 nor with cFTOE. In compromised preterm neonates with lower gestational age and in need of respiratory support CO was associated with crSO2 and cFTOE whereas in stable preterm neonates with higher gestational age as well as in term neonates with and without respiratory support no associations were observed.