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Objective:  To investigate if preterm neonates with arterial oxygen saturation (SpO 2 )<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO 2 ), compared to infants reaching the target.   Methods:  Retrospective analysis of four prospective observational studies. Preterm neonates needing respiratory support during delivery room stabilization were included. Regional cerebral tissue oxygen saturation was measured with near-infrared spectroscopy (NIRS) during the first 15 min after birth along with SpO 2  and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO 2  ≥ 80% (“≥80% group”) and those with a 5-min SpO 2  < 80% (“<80% group”). Groups were compared regarding rcStO 2 , SpO 2 , and HR. Furthermore, we analyzed whether a 5-min SpO 2  < 80% was associated with a rcStO 2  below the 10th percentile at the same time point.   Results:  146 neonates were included, with 68 (47%) in the “≥80% group” and 78 (53%) in the “<80% group.” Neonates in the “ <80% group” had a significantly lower rcStO 2  ( p  < 0.001). Furthermore, 80.3% of neonates in the “ <80% group” and 23.4% in the “≥80% group” had rcStO 2  values below the 10th percentile at 5 min ( p  < 0.001). HR was significantly lower at minute 3 and 4 in the “ <80% group” ( p  < 0.002).   Conclusion:  Preterm infants needing respiratory support, who do not reach the SpO 2  target of 80% at 5 min after birth, show significantly diminished rcStO 2  values compared to neonates reaching the target.

Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation?