Reference Ranges for Cerebral Oxygenation in Neonates During Immediate Transition After Birth: Differences Between Devices

Abstract

Aim: The aim was to define reference ranges for cerebral oxygen saturation (crSO₂-ROOT) during immediate transition after birth in stable neonates.

Methods: In a prospective observational study, the crSO₂-ROOT was continuously measured in neonates during the first 15 min after birth. The neonatal sensor was placed on the head and fixed with a bandage. Median values and 10th and 90th centiles were calculated for each minute. Additionally, cerebral fractional tissue oxygen extraction (cFTOE-ROOT) was calculated using crSO₂-ROOT and arterial oxygen saturation (SpO₂) measured with pulse oximetry. These crSO-ROOT values were compared with already published reference ranges of cerebral oxygen saturation measured using different devices: crSO₂-INVOS and cTOI-NIRO.

Results: The data of 122 neonates (14 preterm/108 term neonates) were analysed. The crSO₂-ROOT values had a similar course when compared to cTOI-NIRO values, whereas crSO₂-INVOS values were initially lower and exceeded during the first minutes after birth.

Conclusion: The present observational study added reference ranges of crSO₂-ROOT in stable neonates immediately after birth. As there are differences regarding reference ranges of various near-infrared spectroscopy (NIRS) devices, it is important to be aware of this information for future clinical use.

Keywords: brain monitoring; cerebral oxygen saturation; near‐infrared spectroscopy; neonatal transition; reference range.