Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation?

To investigate if preterm neonates with arterial oxygen saturation (SpO)<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO), compared to infants reaching the target. Retrospective analysis of four prospective observational studies. Preterm neonates needing respiratory support during delivery room stabilization were included. Regional cerebral tissue oxygen saturation was measured with near-infrared spectroscopy (NIRS) during the first 15 min after birth along with SpO and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO ≥ 80% ("≥80% group") and those with a 5-min SpO < 80% ("<80% group"). Groups were compared regarding rcStO, SpO, and HR. Furthermore, we analyzed whether a 5-min SpO < 80% was associated with a rcStO below the 10th percentile at the same time point. 146 neonates were included, with 68 (47%) in the "≥80% group" and 78 (53%) in the "<80% group." Neonates in the " <80% group" had a significantly lower rcStO ( < 0.001). Furthermore, 80.3% of neonates in the " <80% group" and 23.4% in the "≥80% group" had rcStO values below the 10th percentile at 5 min ( < 0.001). HR was significantly lower at minute 3 and 4 in the " <80% group" ( < 0.002). Preterm infants needing respiratory support, who do not reach the SpO target of 80% at 5 min after birth, show significantly diminished rcStO values compared to neonates reaching the target.