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Cerebral Oxygen Changes in Neonates During Immediate Transition After Birth and Early Life: An Observational Study

Authors Xue H, Wu Z, Yao J, Zhao A, Zheng L, Yin X, Wang F, Zhao P

Received 8 June 2020

Accepted for publication 25 September 2020

Published 2 November 2020 Volume 2020:14 Pages 4703—4715


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Anastasios Lymperopoulos

Hang Xue, Ziyi Wu, Jiaxin Yao, Anqi Zhao, Lanlan Zheng, Xiao Yin, Fang Wang, Ping Zhao

Department of Anesthesiology, Shengjing Hospital, China Medical University, Shenyang 110004, People’s Republic of China

Correspondence: Ping Zhao
Department of Anesthesiology, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang, People’s Republic of China
, 110004 Tel +86-18940258971
Fax + 86-24-23269477

Purpose: The physiologic transition from a fetus to a neonate is composed of a series of complex processes that include changes in cerebral tissue oxygenation saturation (cSO2). Monitoring this process is of great importance. This study aimed to define the cSO2 reference interval in neonates without medical support, extending the measurements until 1 hour after birth, and to determine the incidence of abnormally low or high regional cerebral oxygenation during the neonatal transition.
Patients and Methods: A total of 418 neonates delivered by cesarean section were enrolled. Near-infrared spectroscopy was used to monitor cerebral oxygenation.
Results: We found that cSO2 of the non-oxygen-inhaled intrathecal anesthesia in neonates without medical support increased from about 49.0% in the second minute. Most of them reached cSO2 relative stabilization at 55.7– 81.0% between 7 and 8 minutes after birth. One hour after birth, newborn cSO2 was maintained at 78.0– 87.0%. The low cSO2 rate among babies born under intrathecal anesthesia with and without maternal oxygen inhalation during cesarean sections was approximately 4.5% and 9.0%, respectively.
Conclusion: We reported the trend in cSO2 from 2 minutes after birth to 1 hour in the neonatal nursing room and determined the incidence of abnormal regional cSO2 during this neonatal transition period. Anesthesiologists should pay special attention to the risk of cSO2 abnormalities in newborns when managing pregnant women with comorbidities.

Keywords: cerebral oxygenation saturation, transitional period after birth, cesarean section, anesthetic monitoring

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