Reference Ranges for Cerebral Oxygenation in Neonates During Immediate Transition After Birth: Differences Between Devices.

Aim: The aim was to define reference ranges for cerebral oxygen saturation (crSO-ROOT) during immediate transition after birth in stable neonates.

Methods: In a prospective observational study, the crSO-ROOT was continuously measured in neonates during the first 15 min after birth. The neonatal sensor was placed on the head and fixed with a bandage.

Surfactant administration and cerebral oxygenation and perfusion in preterm neonates - A systematic review of literature.

Background: Surfactant replacement is standard for preterm neonates with respiratory distress syndrome, improving survival and outcomes. Less invasive surfactant administration (LISA) and intubation-surfactant-extubation (INSURE) are preferred methods for surfactant replacement in spontaneously breathing preterm neonates. Despite the undeniable benefits of surfactant implementation in neonatal care, surfactant administration can affect vital parameters and cerebral oxygenation and perfusion, assessed by near-infrared spectroscopy (NIRS).

Impact of in situ simulation training on quality of postnatal stabilization and resuscitation-a before-and-after, non-controlled quality improvement study.

Unlabelled: This study aimed to evaluate the impact of in situ simulation-based training on quality indicators of patient care at a level IV neonatal intensive care unit. A before-and-after, non-controlled quality improvement study was performed at the Division of Neonatology, Medical University of Graz. The educational intervention comprised a period of 4 months, with structured in situ simulation training delivered regularly for neonatal providers and nurses in interprofessional teams.

Cerebral oxygenation during immediate fetal-to-neonatal transition and fidgety movements between six to 20 weeks of corrected age: An ancillary study to the COSGOD III trial.

Fidgety movements provide early information about a potential development of cerebral palsy in preterm neonates. The aim was to assess differences in the combined outcome of mortality and fidgety movements defined as normal or pathological in very preterm neonates according to the group allocation in the randomised-controlled multicentre COSGOD III trial. Preterm neonates of two centres participating in the COSGOD III trial, whose fidgety movements were assessed as normal or pathological at six to 20 weeks of corrected age, were analysed.

Reference ranges of peripheral-muscle oxygenation in term neonates delivered by Caesarean section during immediate transition after birth.

Aim: To establish reference ranges of peripheral-muscle regional oxygen saturation (prSO) and peripheral fractional tissue oxygen extraction (pFTOE) during the first 15 min after birth in stable term neonates.

Methods: Secondary outcome parameters of prospective observational studies in healthy term neonates delivered by Caesarean section were analysed. prSO was measured on the right forearm using the INVOS 5100C monitor.

Peripheral arterial catheters in extremely preterm infants born at less than 28 weeks of gestation-a single-center experience.

The aim of this study was to perform a retrospective data analysis of established peripheral artery catheters (pAC) in extremely preterm infants. The primary outcome was the pAC life span and its correlation to gestational age, birth weight, localizations, and pAC removal. Retrospective data analysis of electronic patient records of all extremely preterm infants (born less than 28 weeks gestation) admitted to the neonatal intensive care unit in Graz (Austria) between January 2014 and December 2020.

Cerebral fractional tissue oxygen extraction (cFTOE) during immediate fetal-to-neonatal transition: a systematic qualitative review of the literature.

Unlabelled: Cerebral monitoring during immediate fetal-to-neonatal transition is of increasing interest. The cerebral fractional tissue oxygen extraction (cFTOE) is a useful parameter to gain insight in the balance between tissue oxygen delivery and consumption during this complex process. The aim of this study was to review the literature on cFTOE during the first 15 min immediately after birth.

Cardiac output calculation using the Liljestrand and Zander formula: is this method applicable during immediate transition after birth? - A post hoc analysis.

The transition from intrauterine to extrauterine life is a critical period for neonates. Assessing the cardiovascular transition during this period immediately after birth is crucial but challenging. The present study compares adjusted estimated cardiac output values calculated by the Liljestrand and Zander formula (COest/adj LaZ) with non-invasively measured cardiac output values (CO-bioimpedance) during immediate transition after birth.

Acid base and metabolic parameters of the umbilical cord blood and cerebral oxygenation immediately after birth.

Objective: Aim was to investigate whether acid-base and metabolic parameters obtained from arterial umbilical cord blood affect cerebral oxygenation after birth in preterm neonates with respiratory support and in term neonates without respiratory support.

Study Design: This was a post-hoc analysis of secondary outcome parameters of a prospective observational study including preterm neonates with and term neonates without respiratory support. Non-asphyxiated neonates with cerebral oxygenation measured with near-infrared spectroscopy during the first 15 min and with blood gas analyses from arterial umbilical cord blood were included.

Coupling between Regional Oxygen Saturation of the Brain and Vital Signs during Immediate Transition after Birth.

Introduction: The primary aim was to analyze any coupling of heart rate (HR)/arterial oxygen saturation (SpO2) and regional cerebral oxygen saturation (rScO2) and regional cerebral fractional tissue oxygen extraction (cFTOE) during immediate transition after birth in term and preterm neonates to gain more insight into interactions.

Methods: The present study is a post hoc analysis of data from 106 neonates, obtained from a prospective, observational study. Measurements of HR, SpO2, rScO2, and cFTOE were performed during the first 15 min after birth.

Multicentre, randomised controlled trial of physiological-based cord clamping versus immediate cord clamping in infants with a congenital diaphragmatic hernia (PinC): statistical analysis plan.

Background: Infants born with congenital diaphragmatic hernia (CDH) are at high risk of respiratory insufficiency and pulmonary hypertension. Routine practice includes immediate clamping of the umbilical cord and endotracheal intubation. Experimental animal studies suggest that clamping the umbilical cord guided by physiological changes and after the lungs have been aerated, named physiological-based cord clamping (PBCC), could enhance the fetal-to-neonatal transition in CDH.

Two-year neurodevelopmental outcome in extremely preterm-born children: The Austrian Preterm Outcome Study Group.

Aim: The current study determined the neurodevelopmental outcome of extremely preterm infants at 2 years of age.

Methods: All live-born infants 23-27 weeks of gestation born between 2011 and 2020 in Austria were included in a prospective registry. Neurodevelopmental outcome at 2 years of corrected age was assessed using Bayley Scales of Infant Development for both motor and cognitive scores, along with a neurological examination and an assessment of neurosensory function.

Physiological-based cord clamping stabilised cardiorespiratory parameters in very low birth weight infants.

Aim: We investigated the influence of physiological-based cord clamping (PBCC) on cardiorespiratory stability in very low birth weight (VLBW) infants during the first 72 h of life.

Methods: This retrospective study comprised VLBW infants born at <32 + 0 weeks of gestation and admitted to the neonatal intensive care unit of the Medical University of Graz, Austria, from December 2014 to April 2021. VLBW infants delivered with PBCC were matched by gestational age and birth weight to delayed cord clamping controls.

Sustained decrease in latent safety threats through regular interprofessional in situ simulation training of neonatal emergencies.

Simulation training at trainees' actual workplace offers benefits over traditional simulation-based team training. We prospectively investigated whether regular in situ simulation training of neonatal emergencies in an interprofessional and interdisciplinary team could be used to identify and rectify latent safety threats (LSTs).For this purpose, we conducted 1-day in situ simulation trainings at the Department of Gynaecology and Obstetrics, Feldbach, Austria, targeting anaesthesiologists, obstetricians, midwives, nurses and consultant paediatricians.

Peripheral muscle fractional tissue oxygen extraction in stable term and preterm neonates during the first 24 h after birth.

Background: Peripheral muscle fractional tissue oxygen extraction (pFTOE) represents the relative extraction of oxygen from the arterial to venous compartment, providing information about dynamic changes of oxygen delivery and oxygen consumption. The aim of the present study was to establish reference values of pFTOE during the first 24 h after birth in stable term and late preterm neonates.

Methods: The present study is a analysis of secondary outcome parameters of prospective observational studies.

Precision and normal values of cerebral blood volume in preterm neonates using time-resolved near-infrared spectroscopy.

Aim: To investigate cerebral blood volume (CBV) in preterm neonates using time-resolved near-infrared spectroscopy.

Methods: In this prospective observational study, time-resolved near-infrared spectroscopy measurements of CBV using tNIRS-1 were performed in 70 preterm neonates. For measurements, a sensor was placed for a duration of 1 min, followed by four further reapplications of the sensor, overall five measurements.

Insights into Neonatal Cerebral Autoregulation by Blood Pressure Monitoring and Cerebral Tissue Oxygenation: A Qualitative Systematic Review.

Objective: The aim of this qualitative systematic review was to identify publications on blood pressure monitoring in combination with cerebral tissue oxygenation monitoring during the first week after birth focusing on cerebral autoregulation.

Methods: A systematic search was performed on PubMed. The following search terms were used: infants/newborn/neonates, blood pressure/systolic/diastolic/mean/MAP/SAP/DAP, near-infrared spectroscopy, oxygenation/saturation/oxygen, and brain/cerebral.

Acid-base and metabolic parameters and cerebral oxygenation during the immediate transition after birth-A two-center observational study.

Objective: The association between blood glucose level and cerebral oxygenation (cerebral regional oxygen saturation [crSO2] and cerebral fractional tissue oxygen extraction [FTOE]) in neonates has already been described. Aim of the present study was to investigate if acid-base and other metabolic parameters have an impact on cerebral oxygenation immediately after birth in preterm and term neonates.

Study Design: Post-hoc analyses of secondary outcome parameters of two prospective observational studies were performed.

Cerebral Oximetry Monitoring in Extremely Preterm Infants.

Background: The use of cerebral oximetry monitoring in the care of extremely preterm infants is increasing. However, evidence that its use improves clinical outcomes is lacking.

Methods: In this randomized, phase 3 trial conducted at 70 sites in 17 countries, we assigned extremely preterm infants (gestational age, <28 weeks), within 6 hours after birth, to receive treatment guided by cerebral oximetry monitoring for the first 72 hours after birth or to receive usual care.

Cerebral oxygenation immediately after birth and long-term outcome in preterm neonates-a retrospective analysis.

Background: Prematurity is associated with increased risk for morbidity and mortality. Aim of this study was to evaluate whether cerebral oxygenation during fetal-to-neonatal transition period was associated with long-term outcome in very preterm neonates.

Methods: Preterm neonates ≤ 32 weeks of gestation and/or ≤ 1500 g with measurements of cerebral regional oxygen saturation (crSO) and cerebral fractional tissue oxygen extraction (cFTOE) within the first 15 min after birth were analysed retrospectively.

Clinical NEC prevention practices drive different microbiome profiles and functional responses in the preterm intestine.

Preterm infants with very low birthweight are at serious risk for necrotizing enterocolitis. To functionally analyse the principles of three successful preventive NEC regimens, we characterize fecal samples of 55 infants (<1500 g, n = 383, female = 22) longitudinally (two weeks) with respect to gut microbiome profiles (bacteria, archaea, fungi, viruses; targeted 16S rRNA gene sequencing and shotgun metagenomics), microbial function, virulence factors, antibiotic resistances and metabolic profiles, including human milk oligosaccharides (HMOs) and short-chain fatty acids (German Registry of Clinical Trials, No.: DRKS00009290).

Cardiac output and regional-cerebral-oxygen-saturation in preterm neonates during immediate postnatal transition: An observational study.

Aim: To examine potential correlations between cardiac output (CO) with cerebral-regional-oxygen-saturation (crSO ) and cerebral-fractional-tissue-oxygen-extraction (cFTOE) during immediate foetal-to-neonatal transition in term and preterm neonates with and without respiratory support.

Methods: Post hoc analyses of secondary outcome parameters of prospective observational studies were performed. We included neonates with cerebral near-infrared-spectroscopy (NIRS) monitoring and an oscillometric blood pressure measurement at minute 15 after birth.