The Consensus on Resuscitation Science and Treatment Recommendations indicate the target SpO2 values during the first 10 min of life. There are a few studies of values of brain regional saturation of oxygen (rSO2) in newborns, conventional instruments are large and not suitable for measuring in the delivery room. The purpose of this study was to develop reference values for brain rSO2 up to 10 min after birth and to review the changes in cerebral oxygenation in late preterm and term newborn infants immediately after birth.
Method: We evaluated both brain rSO2 and SpO2 at 1, 3, 5 and 10 min after birth in 100 neonates. rSO2, was measured at the forehead using a finger-mounted oximeter. This is 1/100 the size of conventional NIRS and can be carried. To measure SpO2, a Radical-7 was used. This study was approved by the institutional review board at our hospital.
Results: The gestational age and birth weight were 37.9 ± 1.2 weeks and 2825 ± 429 g, respectively. Eighty-seven infants and 13 infants were term and late preterm infants, respectively, and there were 21 vaginal deliveries and 79 cesarean sections. In all cases, rSO2 levels were measured at 1, 3, 5, and 10 min after birth. For the SpO2 measurements, nine cases at 1 min, 40 cases at 3 min, 81 cases at 5 min and 93 cases at 10 min were available. The median rSO2 level was 43% at 1 min after birth, 48% at 3 min, 52% at 5 min and 57% at 10 min.
Conclusion: We used a finger-mounted oximeter to observe changes in brain rSO2 values of 100 normal transition infants. It was easier to detect rSO2 in comparison to the peripheral oxygen saturation monitored by our pulse oximeter. Brain rSO2 values might be useful to evaluate oxygenation immediately after birth.
Keywords: Brain Oxygenation; Near-infrared spectroscopy; Neonatal cardio-pulmonary resuscitation; Regional saturation of oxygen; SpO2.