Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm - 18/09/24

Doi : 10.1016/j.jpeds.2024.114132

Christina H. Wolfsberger, PhD ^1,², Bernhard Schwaberger, PhD ^1,², Berndt Urlesberger ^1,² : Prof, Alexander Avian ³ : Prof, Katharina Goeral, PhD ⁴, Marlene Hammerl, PhD ⁵, Tina Perme, PhD ⁶, Eugene M. Dempsey ⁷ : Prof, Laila Springer ⁸ : Prof, Gianluca Lista ⁹ : Prof, Tomasz Szczapa ¹⁰ : Prof, Hans Fuchs ¹¹ : Prof, Lukasz Karpinski, PhD ¹⁰, Jenny Bua, MD ¹², Brenda Law, MD ^13,¹⁴, Julia Buchmayer, MD ⁴, Ursula Kiechl-Kohlendorfer ⁵ : Prof, Lilijana Kornhauser-Cerar, PhD ⁶, Christoph E. Schwarz, MD ⁷, Kerstin Gründler, MD ⁸, Ilaria Stucchi, MD ⁹, Katrin Klebermass-Schrehof ⁴ : Prof, Georg M. Schmölzer ^13,¹⁴ : Prof, Gerhard Pichler, MD ^1,^2,^⁎ : Prof
on behalf of the
COSGOD III study group
Nariae Baik-Schneditz, Marlies Bruckner, Corinna Binder-Heschl, Christoph Schlatzer, Johann Martensen, Nina Höller, Evelyn Ziehenberger, Lukas Mileder, Angelika Berger, Sigrid Baumgartner, Agnes Grill, Michaela Mayr, Judith Rittenschober-Boehm, Michael Schneider, Christina Schreiner, Elke Griesmaier, Vera Neubauer, Peter Wöckinger, Anna Posod, Anja Marolt, Ana Dimnik, Vlasta Lubej Kurtovič, Garvey Aisling, Jurate Panaviene, David Healy, Nahla Ahmed, Ita Herlihy, Axel Franz, Francesca Castoldi, Francesco Cavigioli, Zuzanna Kozłowska, Marcin Minta, Zuzanna Owsiańska, Sonia Kahtan, Natalia Neumann- Klimasińska, Karolina Wróbel, Agata Kubiaczyk, Katarzyna Kosik, Katarzyna Olek, Michalina Bugiera, Julita Porwolik, Agnieszka Basiukajć, Elzbieta Czapla, Wojciech Łukaszuk, Katarzyna Gryczka, Dobrochna Naskręcka, Jan Mazela, Marta Szymankiewicz-Bręborowicz, Daniel Klotz, Jana Baumgartner, Jana Bembich, Laura Travan, Po-Yin Cheung

¹ Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
² Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
³ Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
⁴ Comprehensive Center for Pediatrics, Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria
⁵ Department of Pediatrics II, Neonatology, Medical University of Innsbruck, Innsbruck, Austria
⁶ NICU, Division of Gynaecology and Obstetrics, Department for Perinatology, University Medical Centre Ljubljana, Ljubljana, Slovenia
⁷ INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, Ireland
⁸ Department of Neonatology, University Children's Hospital of Tübingen, Tübingen, Germany
⁹ Neonatologia e Terapia Intensiva Neonatale (TIN) Ospedale dei Bambini “V Buzzi,” Milano, Italy
¹⁰ II Department of Neonatology, Neonatal Biophysical Monitoring and Cardiopulmonary Therapies Research Unit, Poznan University of Medical Sciences, Poznan, Poland
¹¹ Division of Neonatology and Pediatric Intensive Care Medicine, Center for Pediatrics and Adolescent Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
¹² Neonatal Intensive Care Unit, Institute for Maternal and Child Health, Trieste, Italy
¹³ Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada
¹⁴ Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada

^∗Reprint requests: Gerhard Pichler, MD, Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz Auenbruggerplatz 34/2, 8036 Graz, Austria.Division of NeonatologyDepartment of Pediatrics and Adolescent MedicineMedical University of GrazAuenbruggerplatz 34/2Graz8036Austria

Abstract

Objective

To define percentile charts for arterial oxygen saturation (SpO₂), heart rate (HR), and cerebral oxygen saturation (crSO₂) during the first 15 minutes after birth in neonates born very or extremely preterm and with favorable outcome.

Study design

We conducted a secondary-outcome analysis of neonates born preterm included in the Cerebral regional tissue Oxygen Saturation to Guide Oxygen Delivery in preterm neonates during immediate transition after birth III (COSGOD III) trial with visible cerebral oximetry measurements and with favorable outcome, defined as survival without cerebral injuries until term age. We excluded infants with inflammatory morbidities within the first week after birth. SpO₂ was obtained by pulse oximetry, and electrocardiogram or pulse oximetry were used for measurement of HR. crSO₂ was assessed with near-infrared spectroscopy. Measurements were performed during the first 15 minutes after birth. Percentile charts (10th to 90th centile) were defined for each minute.

Results

A total of 207 neonates born preterm with a gestational age of 29.7 (23.9-31.9) weeks and a birth weight of 1200 (378-2320) g were eligible for analyses. The 10th percentile of SpO₂ at minute 2, 5, 10, and 15 was 32%, 52%, 83%, and 85%, respectively. The 10th percentile of HR at minute 2, 5, 10, and 15 was 70, 109, 126, and 134 beats/min, respectively. The 10th percentile of crSO₂ at minute 2, 5, 20, and 15 was 15%, 27%, 59%, and 63%, respectively.

Conclusions

This study provides new centile charts for SpO₂, HR, and crSO₂ for neonates born extremely or very preterm with favorable outcome. Implementing these centiles in guiding interventions during the stabilization process after birth might help to more accurately target oxygenation during postnatal transition period.

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Keywords : arterial oxygen saturation, centile charts, cerebral oxygen saturation, heart rate, immediate neonatal transition, neonates born preterm, percentiles, reference ranges

Abbreviations : COSGOD, crSO₂, ECG, FiO₂, HR, NIRS, SpO₂

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Article 114132- octobre 2024 Retour au numéro

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Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm - 18/09/24

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