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  • 1
    Language: English
    In: Acta Paediatrica, 2020-11, Vol.109 (11), p.2299-2301
    Subject(s): Brief Report ; Cerebrovascular Circulation ; Humans ; Infant, Newborn ; Infant, Premature ; preterm infants ; regional cerebal oxygenation ; Regular and Brief Reports ; resistance index ; Ultrasonography, Doppler
    ISSN: 0803-5253
    E-ISSN: 1651-2227
    Source: Alma/SFX Local Collection
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  • 2
    Language: English
    In: PloS one, 2015, Vol.10 (9), p.e0138964-e0138964
    Description: Sustained lung inflations (SLI) during neonatal resuscitation may promote alveolar recruitment in preterm infants. While most of the studies focus on respiratory outcome, the impact of SLI on the brain hasn't been investigated yet. Do SLI affect cerebral blood volume (CBV) in preterm infants? Preterm infants of gestation 28 weeks 0 days to 33 weeks 6 days with requirement for respiratory support (RS) were included in this randomized controlled pilot trial. Within the first 15 minutes after birth near-infrared spectroscopy (NIRS) measurements using 'NIRO-200-NX' (Hamamatsu, Japan) were performed to evaluate changes in CBV and cerebral tissue oxygenation. Two groups were compared based on RS: In SLI group RS was given by applying 1-3 SLI (30 cmH2O for 15 s) continued by respiratory standard care. Control group received respiratory standard care only. 40 infants (20 in each group) with mean gestational age of 32 weeks one day (±2 days) and birth weight of 1707 (±470) g were included. In the control group ΔCBV was significantly decreasing, whereas in SLI group ΔCBV showed similar values during the whole period of 15 minutes. Comparing both groups within the first 15 minutes ΔCBV showed a tendency toward different overall courses (p = 0.051). This is the first study demonstrating an impact of SLI on CBV. Further studies are warranted including reconfirmation of the present findings in infants with lower gestational age. Future investigations on SLI should not only focus on respiratory outcome but also on the consequences on the developing brain. German Clinical Trials Register DRKS00005161 https://drks-neu.uniklinik-freiburg.de/drks_web/setLocale_EN.do.
    Subject(s): Alveoli ; Archives & records ; Birth weight ; Blood ; Blood Volume ; Brain ; Brain - blood supply ; Brain - metabolism ; Brain research ; Cerebral blood flow ; Clinical trials ; Gestation ; Gestational age ; Health aspects ; Humans ; I.R. radiation ; Infant, Newborn ; Infant, Premature ; Infants ; Infants (Premature) ; Inflation (Finance) ; Infrared spectra ; Infrared spectroscopy ; Japan ; Life assessment ; Lung - physiopathology ; Lungs ; Medical research ; Near infrared radiation ; Neonates ; Newborn babies ; Oxygen - metabolism ; Oxygen Inhalation Therapy - methods ; Oxygenation ; Pediatrics ; Physiology ; Pilot Projects ; Randomization ; Research ; Respiration ; Respiration, Artificial - methods ; Respiratory Distress Syndrome, Newborn - physiopathology ; Respiratory Distress Syndrome, Newborn - therapy ; Resuscitation ; Studies ; Usage ; Ventilators
    ISSN: 1932-6203
    E-ISSN: 1932-6203
    Source: Academic Search Ultimate
    Source: PubMed Central
    Source: DOAJ Directory of Open Access Journals - Not for CDI Discovery
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  • 3
    Language: English
    In: Acta Paediatrica, 2018-06, Vol.107 (6), p.952-957
    Description: Aim This study analysed tactile stimulation during neonatal transition and resuscitation in preterm and term neonates born by Caesarean delivery. It examined the frequency, location and body region, duration and possible effects of stimulation on heart rate and arterial oxygen saturation (SpO2). Methods Two independent investigators analysed video recordings of tactile stimulation on term and preterm neonates during neonatal transition from January 2012 to December 2014. They were recorded during a prospective observational study and randomised controlled trial at a tertiary centre, the Medical University of Graz, Austria. SpO2 and heart rate were continuously recorded. Data on the frequency, body region and duration of stimulation were collected. To investigate the possible effects of stimulation, SpO2 and heart rate were compared before and after stimulation. Results Term infants received tactile stimulation more than once, and it tended to start later, last longer and be applied in more locations than in preterm infants. Only preterm infants showed a significant increase in SpO2 after stimulation and heart rates did not show any significant changes in either group. Conclusion Tactile stimulation was applied in different ways to preterm and term infants during neonatal transition and SpO2 showed a significant increase in preterm infants.
    Subject(s): Cesarean section ; Heart beat ; Infants (Newborn) ; Neonatal resuscitation ; Neonatal transition ; Preterm infants ; Tactile stimulation ; Term infants
    ISSN: 0803-5253
    E-ISSN: 1651-2227
    Source: Alma/SFX Local Collection
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  • 4
    Language: English
    In: Acta Paediatrica, 2020-08, Vol.109 (8), p.1560-1569
    Description: Aim Cardiac function is a major factor for tissue perfusion and therefore may affect the tissue oxygen saturation. Aim was to analyse possible associations between cardiac function parameters and cerebral and peripheral tissue oxygenation in neonates on the first day after birth. Methods For the present study, we analysed secondary outcome parameters of a previously performed prospective single centre observational study. The prospective study was conducted at the Medical University of Graz, Austria between September 2011 and June 2013. We included preterm and term neonates who were admitted to the neonatal intensive care unit and in whom simultaneous near‐infrared spectroscopy measurements and echocardiography were obtained on the first day after birth. Cardiac function parameters were correlated to cerebral and peripheral tissue oxygen saturation and cerebral and peripheral fractional tissue oxygen extraction at the time of echocardiography. Results A total of 60 neonates of whom 47 were preterm and 13 were term (median gestational age: 34; IQR 33‐35 weeks, mean birth weight: 2276 ± 774 grams) were included. There were no statistically significant correlations between cardiac function parameters and regional tissue oxygenation parameters. Conclusion In the present study, we found no correlation between regional tissue oxygenation and parameters of cardiac function in cardio‐circulatory stable neonates on the first day after birth.
    Subject(s): Austria ; Brain - diagnostic imaging ; cardiac function ; Cardiovascular Physiological Phenomena ; Cardiovascular System ; Cerebrovascular Circulation ; echocardiography ; Gestational Age ; Humans ; Infant ; Infant, Newborn ; near‐infrared spectroscopy ; neonate ; Oxygen - analysis ; Prospective Studies ; Regular ; Spectroscopy, Near-Infrared ; tissue oxygenation
    ISSN: 0803-5253
    E-ISSN: 1651-2227
    Source: Alma/SFX Local Collection
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  • 5
    Language: English
    In: Archives of disease in childhood. Fetal and neonatal edition, 2015-09, Vol.100 (5), p.F422-F427
    Description: ObjectivesTo investigate the occurrence of peri/intraventricular haemorrhage (P/IVH) in preterm infants and its potential association with cerebral regional oxygen saturation (crSO2) during the immediate transition.MethodsIn this two-centre prospective observational cohort study, crSO2 was measured with near-infrared spectroscopy in preterm infants (〈32 weeks of gestational age) during the immediate neonatal transition (15 min). In addition, arterial oxygen saturation (SpO2) and heart rate (HR) were monitored with pulse oximetry. Cranial ultrasound scans were performed on day 4, day 7 and day 14 after birth and before discharge. Neonates with IVH of any grade (IVH group) were matched to the neonates without IVH (Non-IVH group) on gestational age (±1 week) and birth weight (±100 g). The duration and magnitude of deviation from the 10th centile in crSO2 during immediate transition was analysed and expressed in %minutes.ResultsIVH was found in 12 of the included neonates, who were matched to 12 neonates without IVH. There was no difference in SpO2 and HR between these two groups. The duration and magnitude of centiles-deviation of crSO2 was significantly pronounced in the IVH group compared with the Non-IVH group (1870%min vs 456%min).ConclusionsThe neonates of the IVH group showed significantly lower crSO2 values during the immediate transition, although there was no difference concerning SpO2 and HR. The additional monitoring of crSO2 during the immediate transition could reveal neonates with higher risk of developing an IVH later in the course.
    Subject(s): Abridged Index Medicus ; Birth weight ; Blood pressure ; Brain ; Brain - metabolism ; Care and treatment ; Cerebral Hemorrhage - metabolism ; Cerebrovascular Circulation ; Health aspects ; Heart Rate ; Hemorrhage ; Humans ; Hypoxia ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - metabolism ; Infants (Premature) ; Intensive care ; Ischemia ; Monitoring, Physiologic - methods ; Oximetry ; Oxygen ; Oxygen - blood ; Oxygen Consumption ; Oxygen therapy ; Premature birth ; Prospective Studies ; Risk factors ; Spectroscopy, Near-Infrared ; Spectrum analysis ; Traumatic brain injury ; Ultrasonic imaging ; Usage ; Ventilation
    ISSN: 1359-2998
    E-ISSN: 1468-2052
    Source: Alma/SFX Local Collection
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  • 6
    Language: English
    In: Neonatology (Basel, Switzerland), 2015-11, Vol.108 (4), p.283-286
    Description: Background: Non-invasive monitoring of the brain with near-infrared spectroscopy (NIRS) during immediate transition after birth is of growing interest. Objective: The aim of this work was to define reference ranges and centile charts for a regional cerebral tissue oxygenation index (cTOI), measured with the NIRO 200NX (NIRO, Hamamatsu, Japan), and cerebral fractional tissue oxygen extraction (cFTOE) during the first 15 min after birth in preterm and term neonates without any medical support. Methods: cTOI was measured with the NIRO 200NX during the first 15 min after delivery via Caesarean section in preterm and term infants. The NIRS-sensor was placed on the right forehead. Peripheral arterial oxygen saturation (SpO2) and heart rate were continuously measured by pulse oximetry. cFTOE was calculated out of cTOI and SpO2. Neonates with a requirement for any medical support were excluded. Results: A total of 230 neonates were enrolled, from which 90 had to be excluded. Therefore, 140 term neonates were included and data were used to define reference ranges and centile charts. The 50th centile (10th to 90th centiles) of cTOI was 56% (39-75) at 2 min, 66% (50-78) at 5 min, 75% (62-85) at 10 min and 73% (61-84) at 15 min after birth. The 50th centile of cFTOE was 0.24 (0.11-0.44) at 2 min, 0.20 (0.10-0.35) at 5 min, 0.21 (0.09-0.35) at 10 min and 0.24 (0.13-0.37) at 15 min after birth. Conclusion: The present observational study adds the reference ranges and centile charts of cTOI measured with the NIRO 200NX and cFTOE calculated out of cTOI and SpO2 in neonates during the immediate neonatal transition. Centiles for each instrument will be necessary for future clinical application, since the differences between cTOI and cerebral regional tissue oxygen saturation measured with INVOS 5100C change with increasing regional oxygenation.
    Subject(s): Blood Gas Analysis ; Brain - blood supply ; Cerebral circulation ; Cerebrovascular Circulation - physiology ; Cesarean Section ; Female ; Health aspects ; Heart Rate ; Hemodynamic monitoring ; Humans ; Infant, Newborn ; Infants (Newborn) ; Japan ; Medical examination ; Methods ; Near infrared spectroscopy ; Oximetry ; Oximetry - instrumentation ; Oxygen - analysis ; Pediatric research ; Physiological aspects ; Pregnancy ; Prospective Studies ; Reference Values ; Short Communication ; Spectroscopy, Near-Infrared ; Term Birth - physiology ; Usage
    ISSN: 1661-7800
    E-ISSN: 1661-7819
    Source: Alma/SFX Local Collection
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  • 7
    Language: English
    In: The Journal of pediatrics, 2015, Vol.170, p.73-78.e4
    Description: Objective To assess if monitoring of cerebral regional tissue oxygen saturation (crSO2 ) using near-infrared spectroscopy (NIRS) to guide respiratory and supplemental oxygen support reduces burden of cerebral hypoxia and hyperoxia in preterm neonates during resuscitation after birth. Study design Preterm neonates 〈34+0  weeks of gestation were included in a prospective randomized controlled pilot feasibility study at 2 tertiary level neonatal intensive care units. In a NIRS-visible group, crSO2 monitoring in addition to pulse oximetry was used to guide respiratory and supplemental oxygen support during the first 15 minutes after birth. In a NIRS-not-visible group, only pulse oximetry was used. The primary outcomes were burden of cerebral hypoxia (〈10th percentile) or hyperoxia (〉90th percentile) measured in %minutes crSO2 during the first 15 minutes after birth. Secondary outcomes were all cause of mortality and/or cerebral injury and neurologic outcome at term age. Allocation sequence was 1:1 with block-randomization of 30 preterm neonates at each site. Results In the NIRS-visible group burden of cerebral hypoxia in %minutes, crSO2 was halved, and the relative reduction was 55.4% (95% CI 37.6-73.2%; P  = .028). Cerebral hyperoxia was observed in NIRS-visible group in 3 neonates with supplemental oxygen and in NIRS-not-visible group in 2. Cerebral injury rate and neurologic outcome at term age was similar in both groups. Two neonates died in the NIRS-not-visible group and none in the NIRS-visible group. No severe adverse reactions were observed. Conclusions Reduction of burden of cerebral hypoxia during immediate transition and resuscitation after birth is feasible by crSO2 monitoring to guide respiratory and supplemental oxygen support. Trial registration ClinicalTrials.gov : NCT02017691.
    Subject(s): Abridged Index Medicus ; Cerebrovascular Circulation - physiology ; Feasibility Studies ; Female ; Humans ; Hyperoxia - blood ; Hyperoxia - prevention & control ; Hypoxia, Brain - blood ; Hypoxia, Brain - prevention & control ; Infant ; Infant Mortality ; Infant, Newborn ; Infant, Premature ; Infants (Premature) ; Intensive Care Units, Neonatal ; Male ; Medical informatics ; Monitoring, Physiologic - methods ; Mortality ; Oximetry - methods ; Oxygen - blood ; Oxygen Inhalation Therapy ; Pediatrics ; Pilot Projects ; Prospective Studies ; Resuscitation ; Spectroscopy, Near-Infrared ; Time Factors
    ISSN: 0022-3476
    E-ISSN: 1097-6833
    Source: Backfile Package - All of Back Files EBS [ALLOFBCKF]
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  • 8
    Language: English
    In: Neonatology (Basel, Switzerland), 2015-11, Vol.108 (4), p.253-258
    Description: Background: Near-infrared spectroscopy (NIRS) enables non-invasive measurements of changes in the concentration of oxygenated (ΔHbO2) and reduced (ΔHbR) haemoglobin. Changes in total haemoglobin (ΔHbT = ΔHbO2 + ΔHbR) provide information on changes in cerebral blood volume (CBV). Objective: The aim was to evaluate the behaviour of CBV during immediate postnatal transition in term infants. Design: This observational study was conducted at the Medical University of Graz. NIRS measurements were carried out in term infants without need for respiratory support by using ‘NIRO 200-NX' (Hamamatsu) over the first 15 min after birth. Results: 109 infants with a mean gestational age of 38 + 6 weeks (±7 days) and birth weight of 3,242 g (±481) were included. Related to a reference value at minute 15, a significant decrease of HbT was observed for each minute within the study period. The mean (±SD) decrease of HbT of 17 (±40) µmol/l from minutes 2 to 15 represents a decrease of CBV of 1.0 ml/100 g brain (±2.2). Conclusions: In healthy newborns, CBV decreased over the whole study period. This likely reflects a physiological process. The impact and clinical relevance of different CBV behaviour during immediate transition needs to be investigated in further studies.
    Subject(s): Austria ; Brain - blood supply ; Cerebral circulation ; Cerebrovascular Circulation - physiology ; Female ; Gestational Age ; Health aspects ; Heart Rate ; Hemodynamic monitoring ; Humans ; Infant, Newborn ; Infants (Newborn) ; Male ; Medical examination ; Methods ; Original Paper ; Oxygen - blood ; Oxyhemoglobins - metabolism ; Parturition ; Pediatric research ; Physiological aspects ; Spectroscopy, Near-Infrared
    ISSN: 1661-7800
    E-ISSN: 1661-7819
    Source: Alma/SFX Local Collection
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  • 9
    Language: English
    In: Neonatology (Basel, Switzerland), 2015-02, Vol.107 (2), p.100-107
    Description: Background: The fetal-to-neonatal transition is a complex process that includes changes in cardiac and respiratory systems. Objective: The aim of this study is to review the different methods of cardiocirculatory monitoring during the immediate neonatal transition period. Methods: A systematic search of PubMed and Ovid Embase was performed using the following terms: infant, newborn, newborn infant, neonate, neonates, heart, cardiac, blood pressure, haemodynamic, hemodynamics, blood circulation, circulation, echocardiography, ultrasonography, sonography, electrocardiography, ECG, oximetry, pulse, pulse oximetry, monitoring, measurement, acclimatization, adaptation, transition, after birth and delivery room. Additional articles were identified by manual search of cited references. Only human studies describing cardiocirculatory monitoring during the first 15 min after birth were included. Results: Thirteen studies were identified that described heart rate (HR). Additional five studies were identified that measured blood pressure. Four studies performed functional echocardiography during neonatal transition; two in addition to blood pressure monitoring and three in addition to HR monitoring. Conclusion: Routine HR monitoring using electrocardiography or pulse oximetry is used to evaluate adequate hemodynamic transition, and reference ranges have been established. Measuring blood pressure noninvasively though noncontinuously might be of some value in future, considering that the normative data have been established recently. Echocardiographic monitoring during the immediate transition period will improve the knowledge about cardiac function changes, but introduction in clinical routine remains questionable. © 2014 S. Karger AG, Basel
    Subject(s): Blood Pressure ; Development ; Echocardiography ; Electrocardiography ; Female ; Fetus ; Growth ; Heart Function Tests ; Heart Rate ; Hemodynamic monitoring ; Hemodynamics ; Humans ; Infant, Newborn ; Infants ; Male ; Methods ; Monitoring, Physiologic - methods ; Neonatology ; Oximetry ; Parturition ; Pediatric research ; Research ; Review
    ISSN: 1661-7800
    E-ISSN: 1661-7819
    Source: Alma/SFX Local Collection
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  • 10
    Language: English
    In: Journal of clinical monitoring and computing, 2017-08-19, Vol.32 (3), p.465-469
    Description: Feasibility of cerebral tissue oxygenation measurements immediately after birth has been published starting with first values 2 min after birth. Aim of this study was to evaluate, the time periods from birth and from arrival at the resuscitation table to obtain the first cerebral tissue oxygenation values with two different near infrared spectroscopy (NIRS) devices. The present study is an analysis of exploratory parameters of two prospective observational studies. Cerebral tissue oxygen saturation was measured by the NIRO 200NX measuring “cerebral-tissue-oxygenation-index” (cTOI) or the INVOS5100C measuring “cerebral-regional-oxygen-saturation” (crSO 2 ). Four time periods (T) were defined: T1 birth to arrival at resuscitation table, T2 arrival to application of NIRS sensor, T3 application to first displayed cTOI or crSO 2 value, and T4 from arrival at resuscitation table to first displayed values. Additionally, we compared first displayed values of cTOI and crSO 2 . Thirty neonates were included. Twenty-four were term and six late-preterm neonates. Fifteen neonates measured with NIRO were compared to 15 measured with INVOS. T1 was 49 (6–163) s with NIRO versus 59 (15–87) s with INVOS, T2 14 (4–20) s versus 12 (15–18) s, T3 33 (13–138) s versus 17 (6–290) s and T4 46 (20–153) s and 34 (14–300) s. The first displayed value tended to be higher for cTOI [54% (18–80)] compared to crSO 2 [35% (15–87)]. There were no significant differences between devices in time periods and first values displayed. Cerebral tissue oxygenation can be measured within 1 min after arriving at the resuscitation table in term and preterm neonates after birth without difference between devices.
    Subject(s): Anesthesiology ; Critical Care Medicine ; Health Sciences ; Immediate transition ; Intensive ; Intensive / Critical Care Medicine ; Medicine ; Medicine & Public Health ; Near-infrared-spectroscopy ; Neonate ; Original Research ; Statistics for Life Sciences ; Statistics for Life Sciences, Medicine, Health Sciences ; Time periods
    ISSN: 1387-1307
    E-ISSN: 1573-2614
    Source: Alma/SFX Local Collection
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