METHODS: In this study, a total of 80 term newborns delivered by elective cesarean section were included. Infants were randomly grouped as early (clamped within 15 s, n:40) and delayed cord clamping (at the 60th second, n:40) groups. Peripheral arterial oxygen saturation (SpO2) and heart rate were measured by pulse oximetry while regional oxygen saturation of the brain (rSO2) was measured with near-infrared spectrometer. Fractional tissue oxygen extraction (FTOE) was calculated for every minute between the 3rd and 15th minute after birth. (FTOE = pulse oximetry value-rSO2/pulse oximetry value). The measurements were compared for both groups.
RESULTS: The demographical characteristics, SpO2 levels (except postnatal 6th, 8th, and 14th minutes favoring DCC p < 0.05), heart rates and umbilical cord blood gas values were not significantly different between the groups (p > 0.05). rSO2 values were significantly higher while FTOE values were significantly lower for every minute between the 3rd and 15th minutes after birth in the delayed cord clamping group (p < 0.05).
CONCLUSIONS: Our study revealed a significant increase in cerebral rsO2 values and a decrease in FTOE values in the delayed cord clamping (DCC) group, indicating a positive impact on cerebral oxygenation and hemodynamics. Furthermore, the DCC group exhibited a higher proportion of infants with cerebral rSO2 levels above the 90th percentile. This higher proportion, along with a lower of those with such parameter below the 10th percentile, suggest that DCC may lead to the targeted/optimal cerebral oxygenetaion of these babies. As a result, we recommend measuring cerebral oxygenation, in addition to peripheral SpO2, for infants experiencing perinatal hypoxia and receiving supplemental oxygen.
方法:在本研究中,共纳入80例择期剖宫产分娩的足月新生儿.婴儿被随机分组为早期(在15s内夹住,n:40)和延迟的电源线夹紧(在第60秒,n:40)组。通过脉搏血氧饱和度测量外周动脉血氧饱和度(SpO2)和心率,而使用近红外光谱仪测量大脑的局部氧饱和度(rSO2)。在出生后第3分钟至第15分钟之间,计算每分钟的组织氧提取分数(FTOE)。(FTOE=脉搏血氧饱和度值-rSO2/脉搏血氧饱和度值)。比较两组的测量值。
结果:人口统计学特征,SpO2水平(除了产后6,8th,第14分钟有利于DCCp<0.05),心率和脐血血气值组间差异无统计学意义(p>0.05)。在延迟脐带钳夹组中,出生后第3分钟至第15分钟的每分钟rSO2值显着升高,而FTOE值显着降低(p<0.05)。
结论:我们的研究表明,延迟脐带钳夹(DCC)组的大脑rsO2值显着增加,而FTOE值降低,表明对脑氧合和血流动力学有积极影响。此外,DCC组脑rSO2水平高于第90百分位数的婴儿比例较高。这一比例较高,以及这些参数低于10个百分位数的较低的人,提示DCC可能导致这些婴儿的靶向/最佳脑氧合。因此,我们建议测量脑氧合,除了外周SpO2,对于经历围产期缺氧和接受补充氧气的婴儿。