The influence of perinatal asphyxia on peripheral oxygenation and perfusion in neonates

Abstract

BackgroundPerinatal asphyxia influences peripheral oxygenation and perfusion in neonates. ObjectivesThe aim was to investigate the influence of perinatal asphyxia on peripheral oxygenation and perfusion in neonates by using near-infrared spectroscopy (NIRS). MethodsProspective observational study. Neonates with gestational age >34weeks and birth weight >2000g without infection or congenital malformations were included. Peripheral muscle NIRS measurements in combination with venous occlusion were performed once in the first 48h of life. Tissue oxygenation index (TOI), mixed venous oxygenation (SvO2), fractional oxygen extraction (FOE), haemoglobin flow (Hbflow), oxygen delivery (DO2) and oxygen consumption (VO2) were assessed. Furthermore arterial oxygen saturation, heart rate, blood pressure and temperatures were measured. Neonates with a UapH≤7.15 and an Apgar 5≤6 were compared to neonates with a UapH≥7.15, an Apgar 5≥7 (control group) and a UapH was correlated to NIRS parameters. Results8 asphyxiated neonates were compared to 30 neonates in the control group. TOI (67.7±5.5%) and DO2 (29.0±14.2μmol/100mL/min) were significantly lower in asphyxiated neonates compared to the controls (TOI 71.8±4.9%, p=0.045; DO2 43.9±16.9μmol/100mL/min, p=0.028) and FOE was significantly higher (0.33±0.05) compared to the controls (0.28±0.06, p=0.028). Furthermore significant correlations between UapH and DO2 (r=0.78, p=0.022), VO2 (r=0.80, p=0.018) and FOE (r=−0.75, p=0.034) in the asphyxiated group were found. ConclusionPeripheral oxygenation and perfusion measured with NIRS are compromised in neonates with perinatal asphyxia with worsening of parameters and degree of acidosis in the umbilical cord blood.