Reference Ranges for Arterial Oxygen Saturation, Heart Rate, and Cerebral Oxygen Saturation during Immediate Postnatal Transition in Neonates Born Extremely or Very Preterm
Christina H. Wolfsberger, Bernhard Schwaberger, Berndt Urlesberger, Alexander Avian, Katharina Goeral, Marlene Hammerl, Tina Perme, Eugene Dempsey, Laila Springer, Gianluca Lista, Tomasz Szczapa, Hans Fuchs, Łukasz Karpiński, Jenny Bua, Brenda Hiu Yan Law, Julia Buchmayer, Ursula Kiechl‐Kohlendorfer, Lilijana Kornhauser-Cerar, Christoph E. Schwarz, Kerstin Gründler, Ilaria Stucchi, Katrin Klebermaß-Schrehof, Georg M. Schmölzer, Gerhard Pichler, Nariae Baik‐Schneditz, Marlies Bruckner, Corinna Binder‐Heschl, Christoph Schlatzer, Johann Martensen, Nina Höller, E Ziehenberger, Lukas P. Mileder, Angelika Berger, Sigrid Baumgartner, Agnes Grill, Michaela Mayr, Judith Rittenschober-Boehm, Michael Schneider, Christina Schreiner, Elke Griesmaier, Vera Neubauer, Peter Wöckinger, Anna Posod, Anja Marolt, Ana Dimnik, Vlasta L Kurtovič, Garvey Aisling, Jurate Panaviene, David Healy, Nahla Ahmed, Ita Herlihy, Axel R. Franz, Francesca Castoldi, Francesco Cavigioli, Zuzanna Kozłowska, Marcin Minta, Zuzanna Owsiańska, Sonia Kahtan, Natalia Neumann- Klimasińska, Karolina Wróbel, Agata Kubiaczyk, Katarzyna Kosik, Katarzyna Olek, Michalina Bugiera, Julita Porwolik, Agnieszka Basiukajć, Elzbieta Czapla, Wojciech Łukaszuk, Katarzyna Gryczka, Dobrochna Naskręcka, Jan Mazela, Marta Szymankiewicz‐Bręborowicz, Daniel Klotz, Jana Baumgartner, Jana Bembich, Laura Travan, Po‐Yin Cheung
Abstract
ObjectiveTo define percentile charts for arterial oxygen saturation (SpO2), heart rate (HR), and cerebral oxygen saturation (crSO2) during the first 15 minutes after birth in neonates born very or extremely preterm and with favorable outcome.Study designWe conducted a secondary-outcome analysis of preterm neonates included in the COSGOD III trial with visible cerebral oximetry measurements and with favorable outcome, defined as survival without cerebral injuries until term age. We excluded infants with inflammatory morbidities within the first week after birth. SpO2 was obtained by pulse oximetry, and electrocardiogram or pulse oximetry were used for measurement of HR. CrSO2 was assessed with near-infrared spectroscopy. Measurements were performed during the first 15 minutes after birth. Percentile charts (10th to 90th centile) were defined for each minute.ResultsA total of 207 preterm neonates with a gestational age of 29.7 (23.9-31.9) weeks and a birth weight of 1200 (378-2320) grams were eligible for analyses. The 10th percentile of SpO2 at minute two, five, ten and 15 was 32%, 52%, 83% and 85%, respectively. The 10th percentile of HR at minute two, five, ten and 15 was 70bpm, 109bpm, 126bpm and 134bpm, respectively. The 10th percentile of crSO2 at minute two, five, ten and 15 was 15%, 27%, 59% and 63%, respectively.ConclusionsThis study provides new centile charts for SpO2, HR, and crSO2 for extremely preterm neonates with favorable outcome. Implementing these centiles in guiding interventions during the stabilization process after birth might help to more accurately target oxygenation during postnatal transition period.