• Neonatology · Jan 2013

    A left-to-right shunt via the ductus arteriosus is associated with increased regional cerebral oxygen saturation during neonatal transition.

    • Berndt Urlesberger, Anna Brandner, Mirjam Pocivalnik, Martin Koestenberger, Nicholas Morris, and Gerhard Pichler.
    • Research Unit for Cerebral Development and Oximetry, Division of Neonatology, Medical University of Graz, Graz, Austria. berndt.urlesberger@medunigraz.at
    • Neonatology. 2013 Jan 1;103(4):259-63.

    BackgroundOxygen delivery to the brain is dependent on cardiac output and arterial oxygen content.ObjectivesThe study was designed to investigate the influence of a left-to-right shunt via the ductus arteriosus (DA) on regional oxygen saturation (rSO2) of the brain and peripheral tissue during postnatal transition.MethodsNested case-control study. In term neonates after elective cesarian section, rSO2 of the brain and pre- and postductal peripheral tissue were measured 15 min after uncomplicated postnatal transition. Two groups were formed according to shunt flow characteristics via the DA: shunt group (with a left-to-right shunt), and nonshunt group (no shunt).ResultsOf 80 infants, in 58 (72%) a left-to-right shunt was identified, and in 22 (28%) no flow was seen via the DA. The 22 infants formed the nonshunt group. They were matched with 22 newborn infants with a left-to-right shunt via the DA (shunt group). Infants in the nonshunt group had significantly lower cerebral rSO2 values and higher fractional tissue oxygen extraction and heart rate values. There were no significant differences in regard to peripheral rSO2 values.ConclusionDuring postnatal transition, term infants with a left-to-right shunt via the DA have significantly higher cerebral rSO2 values compared to infants without shunt flow.Copyright © 2013 S. Karger AG, Basel.

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