Author:
Hendrikx Dries,Caicedo Dorado Alexander,Van Huffel Sabine,Naulaers Gunnar,Wolfsberger Christina,Urlesberger Berndt,Pichler Gerhard
Abstract
<b><i>Introduction:</i></b> The primary aim was to analyze any coupling of heart rate (HR)/arterial oxygen saturation (SpO<sub>2</sub>) and regional cerebral oxygen saturation (rScO<sub>2</sub>) and regional cerebral fractional tissue oxygen extraction (cFTOE) during immediate transition after birth in term and preterm neonates to gain more insight into interactions. <b><i>Methods:</i></b> The present study is a post hoc analysis of data from 106 neonates, obtained from a prospective, observational study. Measurements of HR, SpO<sub>2</sub>, rScO<sub>2</sub>, and cFTOE were performed during the first 15 min after birth. The linear and nonlinear correlation were computed between these parameters in a sliding window. The resulting coupling curves were clustered. After clustering, demographic data of the clusters were de-blinded and compared. <b><i>Results:</i></b> Due to missing data, 58 out of 106 eligible patients were excluded. Two clusters were obtained: cluster 1 (<i>N =</i> 39) and cluster 2 (<i>N =</i> 9). SpO<sub>2</sub> had linear and nonlinear correlations with rScO<sub>2</sub> and cFTOE, whereby the correlations with rScO<sub>2</sub> were more pronounced in cluster 2. HR-rScO<sub>2</sub> and HR-cFTOE demonstrated a nonlinear correlation in both clusters, again being more pronounced in cluster 2, whereby linear correlations were mainly absent. After de-blinding, the demographic data revealed that the neonates in cluster 2 had significantly lower gestational age (mainly preterm) compared to cluster 1 (mainly term). <b><i>Discussion:</i></b> Besides SpO<sub>2</sub>, also HR demonstrated a nonlinear correlation with rScO<sub>2</sub> and cFTOE in term and preterm neonates during immediate transition after birth. In addition, the coupling of SpO<sub>2</sub> and HR with cerebral oxygenation was more pronounced in neonates with a lower gestational age.