scholarly journals Impact of Carbon Dioxide on Cerebral Oxygenation and Vital Parameters in Stable Preterm and Term Infants Immediately after Birth

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Christina Helene Wolfsberger ◽  
Marlies Bruckner ◽  
Bernhard Schwaberger ◽  
Lukas Peter Mileder ◽  
Berndt Urlesberger ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Oxygen Saturation ◽  
Preterm Infants ◽  
Gestational Age ◽  
Oxygen Extraction ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Tissue Oxygen ◽  
Term Infants ◽  
The Impact

<b><i>Introduction:</i></b> Carbon dioxide (pCO<sub>2</sub>) induces changes in the tone of cerebral vessels. The aim of the present study was to evaluate the impact of pCO<sub>2</sub> on cerebral regional tissue oxygen saturation (crSO<sub>2</sub>), cerebral fractional tissue oxygen extraction (cFTOE), and cerebral tissue oxygen extraction (cTOE), measured with near-infrared spectroscopy (NIRS), in preterm and term infants 15 min after birth. <b><i>Methods:</i></b> Post hoc analyses of secondary outcome parameters of prospective observational studies were performed. Stable preterm and term infants with cerebral NIRS monitoring (INVOS 5100C) until minute 15 after birth and a blood gas analysis, performed between minutes 14–18 after birth, were included. Heart rate (HR) and arterial oxygen saturation (SpO<sub>2</sub>) were recorded. pCO<sub>2</sub> was correlated with crSO<sub>2</sub>, cFTOE, cTOE, SpO<sub>2</sub>, HR, and partial pressure of oxygen (pO<sub>2</sub>). <b><i>Results:</i></b> Eleven preterm infants with a median (IQR) gestational age of 34.8 (32.7–36.1) weeks were analyzed. Mean ± SD pCO<sub>2</sub> was 53.5 ± 4.2 mm Hg. At minute 15 after birth, crSO<sub>2</sub> was 82.6 (74.3–91.3)%, cFTOE 0.15 ± 0.09, cTOE 14.6 ± 8.4%, SpO<sub>2</sub> 97.4 ± 2.1%, and HR 152 (136–167) bpm. pCO<sub>2</sub> correlated negatively with crSO<sub>2</sub> (<i>p</i> = 0.012) and positively with cFTOE (<i>p</i> = 0.035) and cTOE (<i>p</i> = 0.037). Eighty-four term infants with a gestational age of 39.0 (38.5–38.9) weeks were analyzed. pCO<sub>2</sub> was 53.5 ± 6.3 mm Hg. At minute 15 after birth, crSO<sub>2</sub> was 84.4 (80.8–85.1)%, cFTOE 0.14 ± 0.08, cTOE 13.6 ± 7.9%, SpO<sub>2</sub> 96.5 ± 2.6%, and HR 155 (153–163) bpm. pCO<sub>2</sub> did only negatively correlate with pO<sub>2</sub> (<i>p</i> = 0.034) in term infants. <b><i>Conclusion:</i></b> In preterm infants, higher pCO<sub>2</sub> was associated with lower crSO<sub>2</sub> and higher cFTOE/cTOE. In term infants, no associations were observed. The present findings suggest that the vasodilatative effect of pCO<sub>2</sub> is less pronounced in preterm infants during immediate postnatal transition.

scholarly journals Association between Regional Tissue Oxygenation and Body Temperature in Term and Preterm Infants Born by Caesarean Section

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 205
Author(s):  
Marlies Bruckner ◽  
Lukas P. Mileder ◽  
Alisa Richter ◽  
Nariae Baik-Schneditz ◽  
Bernhard Schwaberger ◽  
...  
Keyword(s):  
Body Temperature ◽  
Caesarean Section ◽  
Oxygen Saturation ◽  
Preterm Infants ◽  
Near Infrared ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Tissue Oxygen Saturation ◽  
Preterm Neonates

Body temperature (BT) management remains a challenge in neonatal intensive care, especially during resuscitation after birth. Our aim is to analyze whether there is an association between the BT and cerebral and peripheral tissue oxygen saturation (crSO2/cTOI and prSO2), arterial oxygen saturation (SpO2), and heart rate (HR). The secondary outcome parameters of five prospective observational studies are analyzed. We include preterm and term neonates born by Caesarean section who received continuous pulse oximetry and near-infrared spectroscopy monitoring during the first 15 min, and a rectal BT measurement once in minute 15 after birth. Four-hundred seventeen term and 169 preterm neonates are included. The BT did not correlate with crSO2/cTOI and SpO2. The BT correlated with the HR in all neonates (ρ = 0.210, p < 0.001) and with prSO2 only in preterm neonates (ρ = −0.285, p = 0.020). The BT was lower in preterm compared to term infants (36.7 [36.4–37.0] vs. 36.8 [36.6–37.0], p = 0.001) and prevalence of hypothermia was higher in preterm neonates (29.5% vs. 12.0%, p < 0.001). To conclude, the BT did not correlate with SpO2 and crSO2/cTOI, however, there was a weak positive correlation between the BT and the HR in the whole cohort and a weak correlation between the BT and prSO2 only in preterm infants. Preterm neonates had a statistically lower BT and suffered significantly more often from hypothermia during postnatal transition.

scholarly journals In preterm infants, ascending intrauterine infection is associated with lower cerebral tissue oxygen saturation and higher oxygen extraction

2015 ◽  
Vol 77 (5) ◽  
pp. 688-695
Author(s):  
Annemiek M. Roescher ◽  
Albertus Timmer ◽  
Michelle E. van der Laan ◽  
Jan Jaap H. M. Erwich ◽  
Arend F. Bos ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Preterm Infants ◽  
Intrauterine Infection ◽  
Oxygen Extraction ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Cerebral Tissue Oxygen Saturation

The influence of intra-aortic balloon counter pulsation on central venous blood oxygen saturation

Perfusion ◽  
2021 ◽  
pp. 026765912110559
Author(s):  
Ayman Mohamed ◽  
Sameh Aboulnaga ◽  
Fayez Hamwi ◽  
Amr S Omar ◽  
Abdulrasheed Pattath ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Venous Blood ◽  
Blood Gases ◽  
Left Ventricular ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Central Venous ◽  
Significant Difference

Objectives We aim at identifying the changes in venous blood saturation values that associates intra-aortic balloon pump (IABP) in cardiac surgery patients with reduced left ventricular function (LVF). Methods A retrospective observational study was conducted in a cardiothoracic intensive care unit (CTICU) in a tertiary cardiac center over 5 years in Qatar. A total of 114 patients with at least moderate impairment of LVF with ejection fraction (EF) less than 40% were enrolled. According to the association of IABP, patients were segregated into two groups with and without IABP (groups 1, 40 patients and group 2, 74 patients). Sequential arterial and venous blood gases were analyzed. The primary outcome was to analyze the changes in the central venous saturation (ScvO2) in both groups and the secondary outcome was to analyze whether these changes affect the overall outcome in terms of intensive care unit (ICU) length of stay. Results There was no significant difference between both groups with regard to age, preoperative EF, hemoglobin, and arterial oxygen saturation (SaO2) in blood gases. Patients with IABP have a higher cScvO2 when compared to the other group (71.5 ± 12.5 vs 63.5 ± 9.3, 68.3 ± 12.6 vs 60.1 ± 9.5, 62.7 ± 10.8 vs 55.63 ± 8.1, and 60.6 ± 7.6 vs 54.9 ± 8.1; p = 0.04, 0.05, 0.03, and 0.5, respectively). However, generalized estimating equations (GEE) analysis showed that compared with the participants showing that there is a decreasing trend in mean levels within the groups during follow-ups, overall difference between both groups’ mean levels was not statistically significant. Conclusions In this study, we observed that after cardiac surgeries, patients with IABP had non-significant higher ScvO2 when compared with a corresponding group with moderate impairment of LVF. Further prospective studies are required to validate these findings.

ALVEOLAR-ARTERIAL O2 AND CO2 DIFFERENCES AND THEIR RELATION TO LUNG VOLUME IN THE NEWBORN

PEDIATRICS ◽  
1968 ◽  
Vol 41 (3) ◽  
pp. 574-587 ◽  
Author(s):  
D. W. Thibeault ◽  
E. Poblete ◽  
P. A. M. Auld
Keyword(s):  
Carbon Dioxide ◽  
Premature Infants ◽  
Lung Volume ◽  
Term Infant ◽  
Full Term ◽  
Arterial Oxygen ◽  
Term Infants ◽  
Oxygen Gradient ◽  
Thoracic Gas Volume ◽  
Gas Volume

Twenty-six premature and five full-term infants, ranging in birth weight from 860 to 4,040 gm and in age from 3 hours to 98 days, were the subjects of this study. Measurements of thoracic gas volume and determination of alveolar-arterial oxygen gradient and arterial-alveolar carbon dioxide gradient were performed. All infants showed a decrease in thoracic gas volume in the first days of life. The initial high thoracic gas volume is thought to be due to trapped gas. The ability to trap gas was demonstrated in a number of infants. In the full-term infant the decrease in thoracic gas volume is associated with improvement in lung function. In the premature infants the decrease in lung volume is associated with a persistently elevated alveolar-arterial oxygen gradient and in an inequality of perfusion and ventilation, as evidenced by the large arterial-alveolar carbon dioxide gradient. In a small group of infants increase in functional residual capacity produced by negative pressure around the chest resulted in a decrease in the carbon dioxide and oxygen gradients, indicating that the infant's lung volume is less than optimum. These observations characterize in physiological terms some of the respiratory difficulties in small premature infants.

Endotracheal suctioning: ventilator vs manual delivery of hyperoxygenation breaths

1996 ◽  
Vol 5 (3) ◽  
pp. 192-197 ◽  
Author(s):  
MJ Grap ◽  
C Glass ◽  
M Corley ◽  
T Parks
Keyword(s):  
Clinical Practice ◽  
Lung Injury ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Arterial Oxygen ◽  
Suction Catheter ◽  
Endotracheal Suctioning ◽  
Arterial Blood ◽  
Before And After ◽  
The Impact

BACKGROUND: Despite a large number of studies on endotracheal suctioning, there is little data on the impact of clinically practical hyperoxygenation techniques on physiologic parameters in critically ill patients. OBJECTIVE: To compare the manual and mechanical delivery of hyperoxygenation before and after endotracheal suctioning using methods commonly employed in clinical practice. METHODS: A quasi-experimental design was used, with twenty-nine ventilated patients with a lung injury index of 1.54 (mild-moderate lung injury). Three breaths were given before and after each of two suction catheter passes using both the manual resuscitation bag and the ventilator. Arterial pressure, capillary oxygen saturation, heart rate, and cardiac rhythm were monitored for 1 minute prior to the intervention to obtain a baseline, continuously throughout the procedure, and for 3 minutes afterward. Arterial blood gases were collected immediately prior to the suctioning intervention, immediately after, and at 30, 60, 120, and 180 seconds after the intervention. Data were analyzed with repeated measures analysis of variance. RESULTS: Arterial oxygen partial pressures were significantly higher using the ventilator method. Peak inspiratory pressures during hyperoxygenation were significantly higher with the manual resuscitation bag method. Significant increases were observed in mean arterial pressure during and after suctioning, with both delivery methods, with no difference between methods. Maximal increases in arterial oxygen partial pressure and arterial oxygen saturation occurred 30 seconds after hyperoxygenation, falling to baseline values at 3 minutes for both methods. CONCLUSION: Using techniques currently employed in clinical practice, these findings support the use of the patient's ventilator for hyperoxygenation during suctioning.

scholarly journals New charts for the assessment of body composition, according to air-displacement plethysmography, at birth and across the first 6 mo of life

2019 ◽  
Vol 109 (5) ◽  
pp. 1353-1360 ◽  
Author(s):  
Tom Norris ◽  
Sara E Ramel ◽  
Patrick Catalano ◽  
Carol ni Caoimh ◽  
Paola Roggero ◽  
...  
Keyword(s):  
United States ◽  
Body Composition ◽  
Preterm Infants ◽  
Fat Mass ◽  
Gestational Age ◽  
The United States ◽  
Fat Free Mass ◽  
Term Infants ◽  
Air Displacement Plethysmography ◽  
Young Infants

ABSTRACT Background Air-displacement plethysmography (ADP) is a good candidate for monitoring body composition in newborns and young infants, but reference centile curves are lacking that allow for assessment at birth and across the first 6 mo of life. Objective Using pooled data from 4 studies, we aimed to produce new charts for assessment according to gestational age at birth (30 + 1 to 41 + 6 wk) and postnatal age at measurement (1–27 wk). Methods The sample comprised 222 preterm infants born in the United States who were measured at birth; 1029 term infants born in Ireland who were measured at birth; and 149 term infants born in the United States and 57 term infants born in Italy who were measured at birth, 1 and 2 wk, and 1, 2, 3, 4, 5, and 6 mo of age. Infants whose birth weights were <3rd or >97th centile of the INTERGROWTH-21st standard were excluded, thereby ensuring that the charts depict body composition of infants whose birth weights did not indicate suboptimal fetal growth. Sex-specific centiles for fat mass (kg), fat-free mass (kg), and percentage body fat were estimated using the lambda-mu-sigma (LMS) method. Results For each sex and measure (e.g., fat mass), the new charts comprised 2 panels. The first showed centiles according to gestational age, allowing term infants to be assessed at birth and preterm infants to be monitored until they reached term. The second showed centiles according to postnatal age, allowing all infants to be monitored to age 27 wk. The LMS values underlying the charts were presented, enabling researchers and clinicians to convert measurements to centiles and z scores. Conclusions The new charts provide a single tool for the assessment of body composition, according to ADP, in infants across the first 6 mo of life and will help enhance early-life nutritional management.

Measurement of brain tissue oxygen saturation in term infants using a new portable near-infrared spectroscopy device

2016 ◽  
Vol 59 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Takaaki Watanabe ◽  
Masato Ito ◽  
Fuyu Miyake ◽  
Ryo Ogawa ◽  
Masanori Tamura ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Brain Tissue ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Term Infants ◽  
Brain Tissue Oxygen

scholarly journals Circulating Peptide YY Concentrations Are Higher in Preterm than Full-Term Infants and Correlate Negatively with Body Weight and Positively with Serum Ghrelin Concentrations

2005 ◽  
Vol 51 (11) ◽  
pp. 2131-2137 ◽  
Author(s):  
Tania Siahanidou ◽  
Helen Mandyla ◽  
Maria Vounatsou ◽  
Dimitris Anagnostakis ◽  
Ioannis Papassotiriou ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Energy Balance ◽  
Food Intake ◽  
Preterm Infants ◽  
Gestational Age ◽  
Peptide Yy ◽  
Full Term ◽  
Term Infants ◽  
Serum Ghrelin

Abstract Background: Peptide YY (PYY) and ghrelin are gastrointestinal tract–derived hormones that play roles in the regulation of food intake and energy balance. Negative energy balance often occurs in hospitalized preterm infants. Methods: To measure serum concentrations of PYY in preterm and full-term infants and to investigate their correlations with anthropometric characteristics, food intake, and serum ghrelin concentrations, we measured serum PYY and ghrelin concentrations by RIA in 62 healthy preterm infants [mean (SD) gestational age, 32.0 (2.1) weeks; postnatal age, 40.9 (14.8) days] and 15 healthy full-term infants of comparable postnatal age. All of the infants were formula-fed every 3 h. Results: PYY concentrations were significantly higher in preterm [1126.2 (215.4) ng/L] than in full-term infants [825.3 (234.4) ng/L; P &lt;0.001]. In the entire study population, serum PYY concentrations correlated negatively with gestational age and anthropometric measurements (birth weight, body weight, body length, body mass index, and head circumference) and positively with serum ghrelin concentrations, whereas there was no significant correlation between PYY concentration and caloric intake or weight gain. Multiple regression analysis, after correction for prematurity, revealed that serum PYY concentrations correlated independently with serum ghrelin concentrations and infant body weight or body mass index. Conclusions: Circulating concentrations of PYY may increase in preterm infants to compensate for the negative body-weight balance. The physiologic mechanisms behind the correlation between PYY and ghrelin remain to be elucidated.

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