AUTHOR=Binder-Heschl Corinna , Pichler Gerhard , Avian Alexander , Schwaberger Bernhard , Baik-Schneditz Nariae , Mileder Lukas , Heschl Stefan , Urlesberger Berndt 

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

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 7 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00274

DOI=10.3389/fped.2019.00274

ISSN=2296-2360

ABSTRACT=Objective: To investigate if preterm neonates with arterial oxygen saturation (SpO2) <80% at 5 minutes after birth show different regional cerebral tissue oxygen saturation (rcStO2), 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 during the first 15 minutes after birth along with SpO2 and heart rate (HR).
Neonates were divided into two groups: those with a 5-minute SpO2 ≥80% (“≥80% group”) and those with a 5-minute SpO2 <80% (“<80% group”). Groups were compared regarding rcStO2, SpO2 and HR. Furthermore, we analyzed whether a 5-minute SpO2 <80% was associated with a rcStO2 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 rcStO2 (p< 0.001). Furthermore, 80.3% of neonates in the “<80% group” and 23.4% in the “≥80% group” had rcStO2 values below the 10th percentile at 5 minutes (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 SpO2 target of 80% at 5 minutes after birth, show significantly diminished rcStO2 values compared to neonates reaching the target.