Oxygen Saturation In Neonates Research Articles

The effects of open and closed suctioning systems on neonatal pain and vital signs in neonatal intensive care units

BackgroundEndotracheal suctioning is a procedure used by neonatal intensive care unit nurses to maximize oxygenation and clear airways of secretions, and is one of the most common painful procedures causing stress in intubated newborns. AimThis aim of this study is to compare the effects of open and closed endotracheal suctioning on pain, peak heart rate and oxygen saturation in neonates on mechanicalventilation. Materials and methodsThis experimental-design study was conducted on 30 newborns who were mechanically ventilated in the tertiary neonatal intensive care unit of a public hospital. First, closed suctioning and then open suctioning was performed on patients during the day. Pain, peak heart rate and oxygen saturation levels were evaluated before, during and 30 min after each suctioning procedure. ResultsOf the newborns included in the study, 53.3 % were male and 36.6 % were admitted to intensive care unit due to a heart defect. No statistically significant differences were found in pain, peak heart rate, or oxygen saturation between the open and closed suctioning methods. However, oxygen saturation levels during suctioning were lower compared to levels before and 30 min after the procedure. Additionally, peak heart rate was lower during suctioning compared to 30 min afterward. ConclusionsThe study concludes that there is no significant difference between open and closed suctioning techniques concerning pain, peak heart rate, and oxygen saturation. Implications to practiceGiven its sterility and ease of use, the closed suction method may be preferable in clinical settings.

The Effect of Yakson Touch on Pain and Physiological Parameters of the Newborn

Background: The stressors faced by the newborn can directly affect the newborn’s sensory development, brain development and organization by causing pain in the newborn. Yakson touch, a traditional Korean cultural practice, is known to reduce the pain in the newborn. Aims: The aim of this study is to examine the effect of Yakson touch applied to the newborn on pain and physiological parameters during the heel prick procedure. Methods: The study was conducted using a randomized controlled trial design (experimental, control). The study sample consisted of 80 newborns (experimental group = 40, control group = 40), all born between 35-40 gestational weeks and considered suitable for clinical conditions. Yakson touch is a technique that involves warm, pressure less, slow, and compassionate touch, following a fixed fifteen-minute protocol. The Yakson touch protocol was initiated for the experimental group before the heel prick procedure. Research data were obtained using the Parent and Baby Information Form, Physiological Parameters Observation Form and Newborn Baby Pain Scale. Data analysis was performed using IBM SPSS V23 and the significance level was taken as p < .05. Results: There was no difference between the experimental and control groups in terms of neonatal oxygen saturation, heart rate, and pain score before, during, and after the procedure (p > .05). There was no difference in cry duration between the two groups before and after the heel prick procedure, but the newborns in the experimental group cried less during the heel prick procedure compared to the control group (p = .007). Conclusion: The newborns in the experimental group, who receives Yakson touch during the heel pricking procedure, had shorter crying times than those in the control group. Therefore, it is recommended to include Yakson touch in nursing interventions during this procedure.

Tiny Lungs, Big Differences: Navigating the Varied COVID-19 Landscape in Neonates vs. Infants via Biomarkers and Lung Ultrasound.

Due to their susceptibilities, neonates and infants face unique SARS-CoV-2 challenges. This retrospective study will compare the illness course, symptoms, biomarkers, and lung damage in neonates and infants with SARS-CoV-2 infection from February 2020 to October 2023. This study was conducted at two hospitals in Timisoara, Romania, using real-time multiplex PCR to diagnose and lung ultrasonography (LUS) to assess lung involvement. Neonates had a more severe clinical presentation, an increased immune response, and greater lung involvement. Neonates had more PCR-positive tests (p = 0.0089) and longer hospital stays (p = 0.0002). In neonates, LDH, CRP, and ferritin levels were higher, indicating a stronger inflammatory response. Reduced oxygen saturation in neonates indicates respiratory dysfunction. The symptoms were varied. Infants had fever, cough, and rhinorrhea, while neonates had psychomotor agitation, acute dehydration syndrome, and candidiasis. This study emphasizes individualized care and close monitoring for neonatal SARS-CoV-2 infections. Newborn lung ultrasonography showed different variances and severity levels, emphasizing the need for targeted surveillance and therapy. Newborns have high lung ultrasound scores (LUSS), indicating significant lung involvement. Both groups had initial lung involvement, but understanding these modest differences is crucial to improving care for these vulnerable populations.

Effect of Prone Position on Oxygen Saturation in Neonates having Respiratory Distress

Objective: To determine the mean change in oxygen saturation of neonates having respiratory distress after prone positioning for six hours.
 Study Design: Quasi experimental Study.
 Place and Duration of Study: Neonatology Unit, Allied Hospital, Faisalabad Pakistan, from Jun to Nov 2015.
 Methodology: Total 60 neonates <28 days of age and >32 weeks of gestation having respiratory distress of both genders were included. All neonates were stabilized after resuscitation (if required) and oxygen saturation was documented with pulse oximeter initially in supine position and then after prone positioning for 6 hours. Statistical analysis of data was done by using SPSS version 20.
 Results: Out of 60 neonates 38(63.3%) were males and 22(36.7%) were females. Male to female ratio was 1.7:1. Their mean age was 1.75±0.68 days. Oxygen saturation in supine position was 76.97±10.12 and after 6 hours in prone position was 85.78±7.40 with p-value of 0.0001 which is statistically significant.
 Conclusion: Prone position results in improvement of oxygen saturation in newborns having respiratory distress.

Cerebral oxygen saturation in neonates: a bedside comparison between neonatal and adult NIRS sensors.

The majority of neonatal NIRS literature recommends target ranges for cerebral saturation (rScO2) based on data using adult sensors. Neonatal sensors are now commonly used in the neonatal intensive care unit (NICU). However, there is limited clinical data correlating these two measurements of cerebral oxygenation. A prospective observational study was conducted in two NICUs between November 2019 and May 2021. An adult sensor was placed on infants undergoing routine cerebral NIRS monitoring with a neonatal sensor. Time-synchronized rScO2 measurements from both sensors, heart rate, and systemic oxygen saturation values were collected over 6 h under varying clinical conditions and compared. Time-series data from 44 infants demonstrated higher rScO2 measurements with neonatal sensors than with adult sensors; however, the magnitude of the difference varied depending on the absolute value of rScO2 (Adult = 0.63 × Neonatal + 18.2). While there was an approximately 10% difference when adult sensors read 85%, readings were similar when adult sensors read 55%. rScO2 measured by neonatal sensors is typically higher than measured by adult sensors, but the difference is not fixed and is less at the threshold indicative of cerebral hypoxia. Assuming fixed differences between adult and neonatal sensors may lead to overdiagnosis of cerebral hypoxia. In comparison to adult sensors, neonatal sensors rScO2 readings are consistently higher, but the magnitude of the difference varies depending on the absolute value of rScO2. Marked variability during high and low rScO2 readings was noted, with approximately 10% difference when adult sensors read 85%, but nearly similar (58.8%) readings when adult sensors read 55%. Estimating fixed differences of approximately 10% between adult and neonatal probes may lead to an inaccurate diagnosis of cerebral hypoxia and result in subsequent unnecessary interventions.

Establishing the reference interval for pulse oxygen saturation in neonates at high altitudes: protocol for a multicentre, open, cross-sectional study

IntroductionEstablishing the reference interval for pulse oxygen saturation (SpO2) is essential for sensitively identifying neonatal hypoxaemia due to various causes. However, the reference interval for high altitudes has not yet...

Effect of uterine fundal pressure applied in the second stage of labor on birth outcomes and neonatal oxygen saturation.

To examine the effect of fundal pressure applied in the second stage of labor on birth outcomes and neonatal O2 saturation. The study is of a descriptive and comparative type. Research data were collected in the obstetrics clinic of a Maternity Hospital between August 15, 2019 and February 15, 2020. The study sample consisted of 160 pregnant women who met the research criteria (80 pregnant women who received fundal pressure, 80 pregnant women who did not receive fundal pressure). The duration of the second and third stages of labor was found to be shorter in the nonfundal pressure group (t=-3.422, p=0.001; t=2.195, p=0.030). When the groups were compared, the formation of perineal trauma and second-degree laceration, episiotomy requirement, elongation of the episiotomy incision and cervical laceration rate were found to be significantly higher in the fundal pressure group χ2 =10.794 p=0.001; χ2 =8.403 p=0.004; χ2 =10.014, p=0.002; χ2 =16.579 p=0.000; χ2 =16.276 p=0.000). The 1st and 5th min Apgar scores of the newborns were lower in the fundal pressure group (t=-6.377, p=0.000; t=-3.581, p=0.001). The 1st, 5th, 10th, and 15th min oxygen saturation of the newborns were determined to be significantly lower in the fundal pressure group (t=-4.753, p=0.000; t=-2.427, p=0.016; t=-2.604, p=0.010; t=-2.492, p=0.014). According to the study results, it was determined that the uterine fundal pressure has a negative effect on birth outcomes and neonatal oxygen saturation. Adverse effects of fundal pressure application should be revealed in different aspects.

Efficacy of Breast Milk Olfactory and Gustatory Interventions on Neonates' Biobehavioral Responses to Pain during Heel Prick Procedures.

This study aimed to evaluate the efficacy of breast milk odor either alone or in combination with breast milk taste (via syringe-feeding) to alleviate neonates’ biobehavioral responses to pain during heel-prick procedures. This prospective randomized controlled trial recruited 114 neonates by convenience sampling from a newborn unit of a medical center in Taiwan. Neonates were randomly assigned to three groups: control (gentle touch + human voice), control + breast milk odor, and control + breast milk odor + breast milk taste. Heart rate, oxygen saturation, and voice recordings of crying were measured across heel-prick procedures: baseline, no stimuli (stage 0); during heel prick (Stages 1–4); and recovery (Stages 5–10). Generalized estimating equations and Kaplan–Meier survival analysis compared differences in changes between groups for heart rate, oxygen saturation, and time to crying cessation. Changes in mean heart rate and oxygen saturation in neonates receiving breast milk odor or breast milk odor + breast milk taste were significantly less than those at the corresponding stage for the control group. Among neonates receiving breast milk odor or breast milk odor + breast milk taste, hazard rate ratios for crying cessation were 3.016 and 6.466, respectively. Mother’s breast milk olfactory and gustatory interventions could stabilize the biobehavioral responses to pain during heel prick procedures in neonates.

Both spontaneous vaginal delivery and elective caesarean section influence neonatal redox status in dogs

The influence of birth mode on redox balance is unknown in dogs. We aimed to compare antioxidant activity and oxidative stress of puppies born by elective c-section or vaginal delivery. Twenty-one bitches were elected for spontaneous vaginal delivery (n=10) and elective cesarean section (n=11) groups, considering only the first and last puppies born. Neonatal oxygen saturation, lactatemia, superoxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GPx) and total antioxidant capacity; marker of oxidative stress (thiobarbituric acid reactive substances [TBARS]) and protein oxidation were analysed at birth, 1h, 12h, 24h and 72 h. C-section newborns had lower oximetry at birth and 1h. Lactatemia was higher in the last vaginal delivery puppies and higher at birth, and 1h. Regardless of birth mode, last puppies had hyperlactatemia at birth. Vaginal delivery puppies had higher TBARS, while protein oxidation was higher in c-section, mostly in last puppies. C-section puppies had higher GPx activity, whereas GSH concentration decreased overtime. Surgically born puppies had lowering SOD between 12h and 72h. Vaginal delivery enhances lipid peroxidation, counteracted mostly by GPx. Conversely, c-section triggers protein oxidation, acutely scavenged by SOD and GSH, thus puppies are less exposed to the negative consequences of oxidative stress.

Cerebral and Somatic Oxygen Saturation in Neonates with Congenital Heart Disease before Surgery.

Background: We investigated preoperative cerebral (ScO2) and abdominal (StO2) regional oxygen saturations according to cardiac diagnosis in neonates with critical CHD, their time trends, and the clinical and biochemical parameters associated with them. Methods: Thirty-seven neonates with a prenatal diagnosis of CHD were included. ScO2 and StO2 values were continuously evaluated using near-infrared spectroscopy. Measurements were obtained hourly before surgery. A linear mixed effects model was used to assess the effects of time and cardiac diagnosis on regional oxygenation and to explore the contributing factors. Results: Regional oxygenation differed according to cardiac diagnosis (p < 0.001). ScO2 was lowest in the patients with severe atrioventricular valvar regurgitation (AVVR) (48.1 ± 8.0%). StO2 tended to be lower than ScO2, and both worsened gradually during the period between birth and surgery. There was also a significant interaction between cardiac diagnosis and time. The factors related to ScO2 were hemoglobin and arterial saturation, whereas no factor was associated with StO2. Conclusions: Preoperative ScO2 and StO2 in critical CHD differed according to cardiac diagnosis. ScO2 in the patients with severe AVVR was very low, which may imply cerebral hypoxia. ScO2 gradually decreased, suggesting that the longer the time to surgery, the higher the risk of hypoxic brain injury.

Assess the Impact of selected Maternal Parameters on Neonatal Oxygen Saturation Levels after Birth through Pre and Post Ductal Saturation monitoring at Pravara Rural Hospital, Loni (Bk)

Assess the Impact of selected Maternal Parameters on Neonatal Oxygen Saturation Levels after Birth through Pre and Post Ductal Saturation monitoring at Pravara Rural Hospital, Loni (Bk)

Thresholds for oximetry alarms and target range in the NICU: an observational assessment based on likely oxygen tension and maturity

BackgroundContinuous monitoring of SpO2 in the neonatal ICU is the standard of care. Changes in SpO2 exposure have been shown to markedly impact outcome, but limiting extreme episodes is an arduous task. Much more complicated than setting alarm policy, it is fraught with balancing alarm fatigue and compliance. Information on optimum strategies is limited.MethodsThis is a retrospective observational study intended to describe the relative chance of normoxemia, and risks of hypoxemia and hyperoxemia at relevant SpO2 levels in the neonatal ICU. The data, paired SpO2-PaO2 and post-menstrual age, are from a single tertiary care unit. They reflect all infants receiving supplemental oxygen and mechanical ventilation during a 3-year period. The primary measures were the chance of normoxemia (PaO2 50–80 mmHg), risks of severe hypoxemia (PaO2 ≤ 40 mmHg), and of severe hyperoxemia (PaO2 ≥ 100 mmHg) at relevant SpO2 levels.ResultsNeonates were categorized by postmenstrual age: < 33 (n = 155), 33–36 (n = 192) and > 36 (n = 1031) weeks.From these infants, 26,162 SpO2-PaO2 pairs were evaluated. The post-menstrual weeks (median and IQR) of the three groups were: 26 (24–28) n = 2603; 34 (33–35) n = 2501; and 38 (37–39) n = 21,058. The chance of normoxemia (65, 95%-CI 64–67%) was similar across the SpO2 range of 88–95%, and independent of PMA. The increasing risk of severe hypoxemia became marked at a SpO2 of 85% (25, 95%-CI 21–29%), and was independent of PMA. The risk of severe hyperoxemia was dependent on PMA. For infants < 33 weeks it was marked at 98% SpO2 (25, 95%-CI 18–33%), for infants 33–36 weeks at 97% SpO2 (24, 95%-CI 14–25%) and for those > 36 weeks at 96% SpO2 (20, 95%-CI 17–22%).ConclusionsThe risk of hyperoxemia and hypoxemia increases exponentially as SpO2 moves towards extremes. Postmenstrual age influences the threshold at which the risk of hyperoxemia became pronounced, but not the thresholds of hypoxemia or normoxemia. The thresholds at which a marked change in the risk of hyperoxemia and hypoxemia occur can be used to guide the setting of alarm thresholds. Optimal management of neonatal oxygen saturation must take into account concerns of alarm fatigue, staffing levels, and FiO2 titration practices.

Neonatal oxygen saturations and blood pressure at school-age in children born extremely preterm: a cohort study.

Objective:To explore the relationship between neonatal oxygen saturation and BP at age 6-7 years in a cohort of infants born extremely preterm.Study Design:Infants <28 weeks gestation were assigned to a higher or lower oxygen saturation target. Oximeter data were monitored throughout the neonatal period. A subset of survivors was seen at age 6. BP was measured and compared by group assignment, achieved saturations, and time spent in hypoxemia (saturations < 80%).Results:There was no difference in systolic or diastolic BP between assigned groups. Median achieved weekly oxygen saturation was not associated with BP. Longer duration of hypoxemia during the first week of age was associated with higher systolic BP.Conclusion:Neither target nor actual median oxygen saturations in this study was associated with BP at school age. Increased duration of hypoxemia in the first postnatal week was associated with higher systolic BP at 6-7 years of age.

Neonatal oxygen saturation alarm compliance –under recognized source of iatrogenic harm? An audit and survey of nursing opinion

PurposeOxygen saturation targeting aims to reduce the harm of hypoxia and hyperoxia. This study audited compliance with neonatal intensive care unit oxygen saturation alarm settings and surveyed nursing opinion to better understand factors that influence our ability to maintain infants within the recommended target range. Design: Audit of practice in a single tertiary neonatal intensive care unit followed by an anonymized survey of nursing opinion. Main outcome variableOxygen saturation alarm setting compliance with local oxygen saturation targeting protocol. ResultsAudit of oxygen saturation alarm limit compliance revealed a high rate of non-compliance, particularly in babies on oxygen with a concerning rate of alarms set at 100% in infants <28 weeks gestation. Our survey revealed a highly skilled workforce who highlighted the challenges of maintaining infants within narrow target ranges. We propose a number of steps that could be taken that may improve oxygen saturation targeting and alarm compliance.

Short report: Post-operative wound infections after the gentle caesarean section

ObjectivesWorldwide, the caesarean section (CS) is the most performed type of surgery and numbers are still rising. The gentle CS has become a more common procedure as it allows the parents to experience birth. Early and continuous skin-to-skin contact between the mother and her newborn is pursued. Parents are not separated from their newborns and stay with their child in the operation theatre and recovery room. However, data are limited on the incidence of surgical site infections (SSI) after gentle CS. The aim of our study was to examine the risk of postoperative wound infections after gentle CS. Secondary outcomes included other maternal complications and neonatal outcomes. Study designIn this multicenter prospective cohort study, all women who underwent an elective gentle CS between January 2015 and January 2017 were eligible. Demographics, per procedural data, maternal complications and neonatal outcomes were collected. The follow-up lasted until six weeks post partum. ResultsOf the 243 performed CSs, two (0.8%) SSIs occurred; one superficial and one deep wound infection. One patient (0.4%) was readmitted for treatment of endometritis. In total, 20 (8.2%) maternal complications were identified. Median time to skin-to-skin contact was 3 minutes (IQR 2–4.25) with a median neonatal oxygen saturation 10 minutes after birth of 95% (IQR 92–98). Mean gestational age was 274 ± 4.1 days (39 + 1 weeks) and mean neonatal pH was 7.28 (±SD 0.07). All children had Apgar scores >7 at 5 minutes after birth. Neonatal admission occurred in 19 cases (7.8%) and neonatal readmission in 10 cases (4.1%). ConclusionThe gentle CS seems to be a safe procedure for both mother and child and is not associated with an increased risk of surgical site infections or direct suboptimal neonatal outcomes. Therefore, more intensive mother-child interaction during CS is allowed.

Cerebral oximetry monitoring in the management of severe hypoxaemia associated with transposition of the great arteries with balloon atrial septostomy

Transposition of the great arteries (D-TGA) is one of the most common congenital heart diseases requiring neonatal surgical intervention. In the desperately ill neonate with TGA and the resultant hypoxaemia, acidemia, and congestive heart failure, improvement is often obtained with balloon atrial septostomy (BAS). Current methods employed to evaluate oxygen delivery and tissue consumption are frequently nonspecific. Near infrared spectroscopy (NIRS) allows a continuous non-invasive measurement of tissue oxygenation which reflects perfusion status in real time. Because little is known about the direct effect of BAS on the neonatal brain and on cerebral oxygenation, we measured the effectiveness of BAS in two patients with D-TGA using NIRS before and after BAS. We concluded BAS improves cerebral oxygen saturation in neonates with D-TGA.

Elevated intrathoracic CO2 pressure during thoracoscopic surgery decreases regional cerebral oxygen saturation in neonates and infants-A pilot study.

Intraoperative hypercapnia and acidosis are risk factors during thoracoscopy in neonates and infants. In a prospective pilot study, we evaluated the effects of thoracoscopy in neonates and infants on cerebral microcirculation, oxygen saturation, and oxygen consumption. Regional cerebral oxygen saturation and blood flow were measured noninvasively using a new device combining laser Doppler flowmetry and white light spectrometry. Additionally, cerebral fractional tissue oxygen extraction and approximated oxygen consumption were calculated. Fifteen neonates and infants undergoing thoracoscopy were studied using the above-mentioned method. The chest was insufflated with carbon dioxide with a pressure of 2-6 mm Hg. Single lung ventilation was not used. As control group served 15 neonates and infants undergoing abdominal surgery. Data are presented as median and range. The 95% confidence intervals for differences of means (95% CI) are given for the mean difference from baseline values. We observed a correlation between intrathoracic pressure exceeding 4 mm Hg and transient decrease in regional cerebral oxygen saturation of 12.7% (95% CI: 9.7-17.2, P<.001). Peripheral oxygen saturation was normal at the same time. Intraoperative increase in arterial paCO2 (median maximum value: 48.8 mm Hg, range: [36.5-65.4]; 95% CI: -16.0 to -3.0, P=.002) and decrease in arterial pH (median minimum value: 7.3, range: [7.2-7.4]; 95% CI: 0.04-0.12, P=.008) were observed during thoracoscopy with both parameters recovering at the end of the procedure. Periods of regional cerebral oxygen saturation below 20% from baseline were significantly more frequent during thoracoscopy as compared to the control group (median maximum value: 1.3%min/h, range: [0.0-66.2] vs median maximum value: 0.0%min/h, range: [0.0-4.0]; 95% CI: -16.6 to -1.1, P=.028). We suggest that thoracoscopic surgery in neonates and infants, although generally safe, may be associated with a decrease in regional cerebral oxygen saturation correlating with the applied intrathoracic pressure. According to our data an inflation pressure >4 mm Hg should be avoided during thoracoscopic surgery.

The Effect of Non-nutritive Sucking on Transcutaneous Oxygen Saturation in Neonates under the Nasal Continuous Positive Airway Pressure (CPAP)

BackgroundSeveral beneficial effects of non-nutritive sucking in infants, including the physiological stability, relaxation, better transition from tube feeding to oral feeding have been reported. But its effect on oxygen saturation in neonates under the Nasal Continuous Positive Airway Pressure (NCPAPو (is not so clear. This study aimed to investigate the effects of non-nutritive sucking on transcutaneous oxygen saturation levels of neonates treated with NCPAP.Materials and MethodsThis quasi-experimental study was done on 25 preterm neonates, hospitalized with a diagnosis of respiratory distress, required NCPAP, in the neonatal intensive care unit (NICU) at the Ayatollah Rouhani Hospital and Babol Clinic, North of Iran. Non-nutritive sucking was elicited by a standard pacifier appropriate to their age one hour a day, and the mean oxygen saturation was measured before and after intervention by cardiopulmonary monitoring (Saadat Co., Iran). Data analyzed using SPSS-18.0 software.ResultsIn the 25 cases studied, the mean oxygen saturation values ​​before performing non-nutritive sucking was 96.31±2.88%, which was changed to 98.35±1.6% after intervention, and this increase was statistically significant (P = 0.004).Results showed that the gender, birth weight and gestational age of neonates had no effect on mean Blood oxygen saturation (SpO2)level.ConclusionAccording to the results, using the non-nutritive sucking in premature neonates under the NCPAP, can improve oxygenation.

0353 : Cerebral tissue oxygen saturation monitoring during balloon atrial septostomy in neonates with transposition of the great arteries. Preliminary data

Balloon atrial septostomy (BAS) increases peripheral oxygen saturation in neonates with transposition of the great vessels (TGV). Effect of BAS on cerebral oxygenation remains little known. We aimed to describe the modification of regional cerebral tissue oxygen saturation (rcSaO 2 ) during the catheterization. we prospectively included 6 neonates with TGV and restrictive inter-atrial shunt who required BAS. BAS was performed in catheterization laboratory by an interventional pediatric cardiologist. rcSaO 2 was measured using near-infrared spectroscopy (NIRS) during the whole procedure. Median rcSa0 2 at the beginning of the procedure was 52.5% ranging from 21% to 78%. Median rcSaSaO 2 after the BAS was 69.5% ranging from 64% to 94%. The rcSa0 2 increased significantly immediately after the BAS (p=0.0273 by Wilcoxon signed rank test). Median rcSa0 2 delta between before and after BAS was 19% ranging from 11 to 43%. The rcSaO 2 delta was higher although not significantly when rcSa02 before the BAS was less than 50% (31% vs 16%, p=0.14). Linear regression analysis revealed that the delta of rcSaO 2 was significantly inversely related to the rcSa0 2 at the beginning of the procedure (Delta= –0.45 x rcSaO 2 av + 45.8, p=0.37, R 2 =0.70). BAS improves cerebral oxygen saturation during the catheterization in neonates with TGV and restrictive inter-atrial shunt. The increase is proportional to the degree of alteration before the procedure.

Comparing near-infrared spectroscopy devices and their sensors for monitoring regional cerebral oxygen saturation in the neonate

Near-infrared spectroscopy (NIRS) is an upcoming clinical method for monitoring regional cerebral oxygen saturation (rScO2) in neonates. There is a growing market offering different devices and sensors. Even though this technique is increasingly clinically applied, little is known about the similarities and/or differences in rScO2 values between the different devices and sensors. The aim of this study was to compare the rScO2 values obtained in (preterm) neonates with all available sensors of three frequently used NIRS devices. Fifty-five neonates admitted to our neonatal intensive care unit (NICU) were included in this study. rScO2 was simultaneously monitored bilaterally with two different NIRS sensors (left and right frontoparietal) for at least 1 h. Then, the sensors were switched, and measurements were collected for at least another hour. We detected a rather close correlation between all investigated sensors from the three different NIRS devices, but absolute rScO2 values showed substantial differences: Bland-Altman analysis showed average differences from 10 to 15%. Although the rScO2 values correlated well between different NIRS sensors, sometimes there were substantial differences between the absolute rScO2 values, which may complicate clinical application.