Purpose: The physiologic transition from a fetus to a neonate is composed of a series of complex processes that include changes in cerebral tissue oxygenation saturation (cSO₂). Monitoring this process is of great importance. This study aimed to define the cSO₂ reference interval in neonates without medical support, extending the measurements until 1 hour after birth, and to determine the incidence of abnormally low or high regional cerebral oxygenation during the neonatal transition.
Patients and Methods: A total of 418 neonates delivered by cesarean section were enrolled. Near-infrared spectroscopy was used to monitor cerebral oxygenation.
Results: We found that cSO₂ of the non-oxygen-inhaled intrathecal anesthesia in neonates without medical support increased from about 49.0% in the second minute. Most of them reached cSO₂ relative stabilization at 55.7– 81.0% between 7 and 8 minutes after birth. One hour after birth, newborn cSO₂ was maintained at 78.0– 87.0%. The low cSO₂ rate among babies born under intrathecal anesthesia with and without maternal oxygen inhalation during cesarean sections was approximately 4.5% and 9.0%, respectively.
Conclusion: We reported the trend in cSO₂ from 2 minutes after birth to 1 hour in the neonatal nursing room and determined the incidence of abnormal regional cSO₂ during this neonatal transition period. Anesthesiologists should pay special attention to the risk of cSO₂ abnormalities in newborns when managing pregnant women with comorbidities.

Keywords: cerebral oxygenation saturation, transitional period after birth, cesarean section, anesthetic monitoring


中文翻译：

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出生后和生命早期过渡期新生儿脑氧的变化：一项观察性研究

目的：从胎儿到新生儿的生理转变由一系列复杂的过程组成，其中包括脑组织氧饱和度 (cSO ₂ ) 的变化。监控这个过程非常重要。本研究旨在确定没有医疗支持的新生儿的 cSO ₂参考区间，将测量延长至出生后 1 小时，并确定新生儿过渡期间异常低或高区域脑氧合的发生率。
患者与方法：共有418名剖宫产新生儿入组。近红外光谱用于监测脑氧合。
结果：我们发现 cSO ₂在没有医疗支持的情况下，新生儿非吸氧鞘内麻醉的比例从第二分钟的约 49.0% 增加。他们中的大多数在出生后 7 到 8 分钟达到 cSO ₂相对稳定在 55.7-81.0%。出生后一小时，新生儿 cSO ₂维持在 78.0-87.0%。在剖宫产期间，在有和没有母体吸氧的情况下，鞘内麻醉下出生的婴儿的低 cSO _{2率分别约为 4.5% 和 9.0%。}
结论：我们报告了新生儿护理室从出生后 2 分钟到 1 小时 cSO ₂的变化趋势，并确定了异常区域 cSO _{2的发生率。}在这个新生儿过渡期。麻醉医师在管理有合并症的孕妇时应特别注意新生儿 cSO _{2异常的风险。}

【关键词】：脑氧合饱和度 产后过渡期 剖宫产 麻醉监测