• Resuscitation · Jul 2021

    Impact of bradycardia and hypoxemia on oxygenation in preterm infants requiring respiratory support at birth.

    • Ilia Bresesti, Alexander Avian, Marlies Bruckner, Corinna Binder-Heschl, Bernhard Schwaberger, Nariae Baik-Schneditz, Georg Schmölzer, Gerhard Pichler, and Berndt Urlesberger.
    • Division of Neonatology, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria; Research Unit of Cerebral Development and Oximetry, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria; NICU "V. Buzzi" Children's Hospital, ASST-FBF-Sacco, Via Castelvetro 32, 20154 Milan, Italy.
    • Resuscitation. 2021 Jul 1; 164: 62-69.

    Aim Of The StudyAnalysis of the impact of bradycardia and hypoxemia on the course of cerebral and peripheral oxygenation parameters in preterm infants in need for respiratory support during foetal-to-neonatal transition.MethodsThe first 15 min after birth of 150 preterm neonates in need for respiratory support born at the Division of Neonatology, Graz (Austria) were analyzed. Infants were divided into different groups according to duration of bradycardia exposure (no Bradycardia, brief bradycardia <2 min, and prolonged bradycardia ≥2 min) and to systemic oxygen saturation (SpO2) value at 5 min of life (<80% or ≥80%). Analysis was performed considering the degree of bradycardia alone (step 1) and in association with the presence of hypoxemia (step 2).ResultsIn step 1, courses of SpO2 differed significantly between bradycardia groups (p = 0.002), while courses of cerebral regional oxygen saturation (crStO2) and cerebral fractional tissue oxygen extraction (cFTOE) were not influenced (p = 0.382 and p = 0.878). In step 2, the additional presence of hypoxemia had a significant impact on the courses of SpO2 (p < 0.001), crStO2 (p < 0.001) and cFTOE (p = 0.045).ConclusionOur study shows that the degree of bradycardia has a significant impact on the course of SpO2 only, but when associated with the additional presence of hypoxemia a significant impact on cerebral oxygenation parameters was seen (crStO2, cFTOE). Furthermore, the additional presence of hypoxemia has a significant impact on FiO2 delivered. Our study emphasizes the importance of HR and SpO2 during neonatal resuscitation, underlining the relevance of hypoxemia during the early transitional phase.Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.

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