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PO-0424 Does Supplementary Oxygen During A Desaturation Cause Cerebral Hyperoxia In Preterm Neonates?
  1. KCW Moerman,
  2. TE Schat,
  3. AGJFvan Zoonen,
  4. AF Bos,
  5. EMW Kooi
  1. Neonatology, Beatrix Children’s Hospital/University Medical Center Groningen, Groningen, Netherlands

Abstract

Background Supplementary oxygen is often administered when preterm neonates experience desaturations i.e. after apnea, sometimes resulting in cerebral hyperoxia during recovery. Whether this post-hypoxic cerebral hyperoxia is induced by the supplementary oxygen, remains unknown.

Aim To compare the regional cerebral oxygen saturation (rcSO2) and cerebral fractional oxygen extraction (cFTOE) following a desaturation, between preterm neonates who did and did not receive supplementary oxygen.

Methods As part of a larger prospective cohort study, near infrared spectroscopy (NIRS) was used to measure rcSO2 during days 2 to 5 after birth. We collected 50 consecutive desaturations (SpO2 <80%). CFTOE was calculated: [(SpO2–rcSO2)/SpO2]. We used a Wilcoxon signed rank test to compare mean rcSO2 and cFTOE ten minutes before to ten minutes after desaturation. The Mann-Whitney U test was used to compare these values in neonates who did and did not receive supplementary oxygen.

Results We included 50 desaturations in 16 preterm neonates (median GA 28+4/7 (range 25+0/7–30+0/7) weeks; birth weight 1144 (800–1630) grams). Supplementary oxygen was administered in 60% of the events. We found higher rcSO2 values following desaturation (mean 76.9%) compared to before desaturation (mean 70.2%, p = 0.001). There was no difference in rcSO2-increase between neonates who did and who did not receive supplementary oxygen (p = 0.79). CFTOE was lower after desaturation (0.17%) compared to cFTOE before desaturation (0.22%, p < 0.001).

Conclusion Cerebral hyperoxia after desaturation in preterm neonates indeed occurs, but is not induced by supplementary oxygen administration. The decrease of cFTOE after desaturation supports the hypothesis that post-hypoxic reperfusion might cause cerebral hyperoxia after desaturation.

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