Open AccessImpact of Carbon Dioxide on Cerebral Oxygenation and Vital Parameters in Stable Preterm and Term Infants Immediately after Birth
Author(s) -
Christina Helene Wolfsberger,
Marlies Bruckner,
Bernhard Schwaberger,
Lukas Mileder,
Berndt Urlesberger,
Gerhard Pichler
Publication year - 2021
Publication title -
neonatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.399
H-Index - 84
eISSN - 1661-7819
pISSN - 1661-7800
DOI - 10.1159/000519636
Subject(s) - pco2 , medicine , gestational age , anesthesia , oxygenation , oxygen saturation , oxygen , pregnancy , chemistry , biology , organic chemistry , genetics
Carbon dioxide (pCO 2 ) induces changes in the tone of cerebral vessels. The aim of the present study was to evaluate the impact of pCO 2 on cerebral regional tissue oxygen saturation (crSO 2 ), 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. Methods: 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 2 ) were recorded. pCO 2 was correlated with crSO 2 , cFTOE, cTOE, SpO 2 , HR, and partial pressure of oxygen (pO 2 ). Results: Eleven preterm infants with a median (IQR) gestational age of 34.8 (32.7–36.1) weeks were analyzed. Mean ± SD pCO 2 was 53.5 ± 4.2 mm Hg. At minute 15 after birth, crSO 2 was 82.6 (74.3–91.3)%, cFTOE 0.15 ± 0.09, cTOE 14.6 ± 8.4%, SpO 2 97.4 ± 2.1%, and HR 152 (136–167) bpm. pCO 2 correlated negatively with crSO 2 ( p = 0.012) and positively with cFTOE ( p = 0.035) and cTOE ( p = 0.037). Eighty-four term infants with a gestational age of 39.0 (38.5–38.9) weeks were analyzed. pCO 2 was 53.5 ± 6.3 mm Hg. At minute 15 after birth, crSO 2 was 84.4 (80.8–85.1)%, cFTOE 0.14 ± 0.08, cTOE 13.6 ± 7.9%, SpO 2 96.5 ± 2.6%, and HR 155 (153–163) bpm. pCO 2 did only negatively correlate with pO 2 ( p = 0.034) in term infants. Conclusion: In preterm infants, higher pCO 2 was associated with lower crSO 2 and higher cFTOE/cTOE. In term infants, no associations were observed. The present findings suggest that the vasodilatative effect of pCO 2 is less pronounced in preterm infants during immediate postnatal transition.