Impact of Carbon Dioxide on Cerebral Oxygenation and Vital Parameters in Stable Preterm and Term Infants Immediately after Birth

Christina Helene Wolfsberger, Marlies Bruckner, Bernhard Schwaberger, Lukas Peter Mileder, Berndt Urlesberger, Gerhard Pichler
2021 Neonatology  
<b><i>Introduction:</i></b> Carbon dioxide (pCO<sub>2</sub>) induces changes in the tone of cerebral vessels. The aim of the present study was to evaluate the impact of pCO<sub>2</sub> on cerebral regional tissue oxygen saturation (crSO<sub>2</sub>), 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. <b><i>Methods:</i></b> Post hoc analyses of
more » ... y 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<sub>2</sub>) were recorded. pCO<sub>2</sub> was correlated with crSO<sub>2</sub>, cFTOE, cTOE, SpO<sub>2</sub>, HR, and partial pressure of oxygen (pO<sub>2</sub>). <b><i>Results:</i></b> Eleven preterm infants with a median (IQR) gestational age of 34.8 (32.7–36.1) weeks were analyzed. Mean ± SD pCO<sub>2</sub> was 53.5 ± 4.2 mm Hg. At minute 15 after birth, crSO<sub>2</sub> was 82.6 (74.3–91.3)%, cFTOE 0.15 ± 0.09, cTOE 14.6 ± 8.4%, SpO<sub>2</sub> 97.4 ± 2.1%, and HR 152 (136–167) bpm. pCO<sub>2</sub> correlated negatively with crSO<sub>2</sub> (<i>p</i> = 0.012) and positively with cFTOE (<i>p</i> = 0.035) and cTOE (<i>p</i> = 0.037). Eighty-four term infants with a gestational age of 39.0 (38.5–38.9) weeks were analyzed. pCO<sub>2</sub> was 53.5 ± 6.3 mm Hg. At minute 15 after birth, crSO<sub>2</sub> was 84.4 (80.8–85.1)%, cFTOE 0.14 ± 0.08, cTOE 13.6 ± 7.9%, SpO<sub>2</sub> 96.5 ± 2.6%, and HR 155 (153–163) bpm. pCO<sub>2</sub> did only negatively correlate with pO<sub>2</sub> (<i>p</i> = 0.034) in term infants. <b><i>Conclusion:</i></b> In preterm infants, higher pCO<sub>2</sub> was associated with lower crSO<sub>2</sub> and higher cFTOE/cTOE. In term infants, no associations were observed. The present findings suggest that the vasodilatative effect of pCO<sub>2</sub> is less pronounced in preterm infants during immediate postnatal transition.
doi:10.1159/000519636 pmid:34710875 fatcat:zwjkcmool5fihnamqh2shy3mjq