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Hemodynamics and cerebral oxygenation in the neonatal transition: a prospective pilot study
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DOI：10.3345/cep.2025.02572.png)
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Abstract
En 中文
Background: The impact of arterial blood pressure on cerebral oxygenation during immediate postnatal transi tion is poorly understood. Purpose: Here we investigated the association between arterial blood pressure (BP), cerebral tissue oxygenation index (cTOI), and cerebral fractional tissue oxygen ex traction (cFTOE) during the immediate postnatal transi tion in preterm and full term neonates. Methods: This prospective observational study included preterm and term neonates who did versus did not require respiratory support. Oscillometric BP was measured at 5, 10, and 15 minutes after birth. cTOI was continuously monitored using near infrared spectroscopy, while ar terial oxygen saturation (SpO2) was recorded using pulse oximetry. cFTOE was calculated from cTOI and SpO. cTOI and cFTOE values were correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) at all time points. Correlation and mixed model analyses were then performed. Results: A total of 102 neonates were enrolled: 51 preterm (33 with, 18 without respiratory support) and 51 term (14 with, 37 without respiratory support). In preterm neonates requiring respiratory support, cTOI was positively corre lated with DABP at all time points and with MABP at 15 minutes. cFTOE was negatively correlated with MABP and DABP throughout the experiment and with SABP at 5 minutes. No significant correlations were observedamong the other groups. A mixed model analysis showed that MABP and DABP were significantly associated with cFTOE but not cTOI independent of gestational age or respiratory support. Conclusion: Among preterm neonates requiring res piratory support, cTOI and cFTOE were associated with arterial BP during the immediate neonatal transition. Only cFTOE showed a slight association with BP among stable preterm and full term neonates. These fin dings suggest impaired cerebral autoregulation in compromi sed preterm infants during the immediate postnatal transition.
Keywords:
Blood pressure
Premature infant
Cerebro vascular circulation
Near infrared spectroscopy
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