Author Of 3 Presentations

PERIPHERAL FRACTIONAL TISSUE OXYGEN EXTRACTION IN PRETERM NEONATES WITH INFECTION/INFLAMMATION

Abstract

Background

Disturbances of peripheral (micro-)circulation and oxygenation may be the first clinical signs of infection/inflammation especially in neonates.

Objectives

The aim of the present study was to analyse peripheral muscle fractional tissue oxygen extraction (pFTOE) to investigate any changes in neonates with inflammation/infection.

Methods

In this observational study secondary outcome parameters of prospective studies were analysed. Preterm neonates <37 weeks of gestation were included, in whom peripheral muscle oxygenation was measured by near infrared spectroscopy (NIRS: NIRO 200 Hamamatsu, Japan) during 24 hours starting within 6 hours after birth. Neonates with laboratory signs of infection/inflammation on the first or second day after birth (CRP>10 and/or leucocytes>34.000/µl and/or positive blood culture) were matched for birthweight and gestational age to neonates without signs of infection/inflammation (matching ratio: 1:3). For analyses mean values of pFTOE of 3-hours-intervals was calculated and compared between the two groups.

Results

10 preterm neonates with infection/inflammation (gestational age: 32.3±2.2 weeks) were matched and compared to 30 preterm neonates without infection/inflammation (gestational age: 32.3±1.9 weeks). pFTOE was significantly higher in preterm neonates with infection/inflammation at each 3-hour-interval during the 24 hours measurement period compared to preterm neonates without infection/inflammation.

Conclusion

pFTOE is elevated during the first day after birth in preterm neonates. pFTOE measured during the first day after birth might become a new tool that helps in the early diagnosis of infection/inflammation in preterm neonates.

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CEREBRAL BLOOD VOLUME AND OXYGEN SATURATION DURING POSTNATAL STABILIZATION IN THE DELIVERY ROOM

Abstract

Background

In healthy newborn infants, cerebral blood volume (CBV) physiologically decreases immediately after birth. In neonates receiving respiratory support (RS) the change of cerebral blood volume (ΔCBV) is significantly smaller, most probably due to less oxygen delivery to the brain.

Objectives

The aim of this study was to investigate whether preterm neonates receiving RS and having SpO2 values below 80% 5 minutes after birth show differences in ΔCBV, compared to neonates reaching the SpO2 target of 80% or above.

Methods

We retrospectively analysed data from five prospective observational studies, including preterm neonates receiving RS during delivery room stabilization. ΔCBV was measured with near-infrared spectroscopy during the first 15 minutes after birth using the NIRO 200-NX device (Hamamatsu, Japan). Depending on the SpO2, neonates were divided into two groups: those with a 5-minute SpO2 ≥80% (≥80% group) and those with a 5-minute SpO2 <80% (<80% group).

Results

Fifty-two preterm neonates were included, 25 of whom (48.1%) were allocated to the “≥80% group” and 27 (51.9%) to the “<80% group”. There was a decrease in CBV in the “≥80% group”, whereas CBV remained unchanged in the “<80% group”. We found significant group differences for ΔCBV at minutes 3 and 4, compared to the reference values at minute 15 after birth.

Conclusion

Preterm neonates who received RS during delivery room stabilization reaching the SpO2 target of 80% at 5 minutes after birth showed a decrease in CBV. In contrast, CBV remained unchanged in the “<80% group”, which seems to be a pathological finding.

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IMPACT OF PARENTAL AGE ON PARENTAL STRESS EXPERIENCE AFTER BIRTH OF A PRETERM NEONATE ADMITTED TO NICU

Abstract

Background

Preterm birth is often associated with increased parental stress, worry and anxiety, during and after admission to a Neonatal Intensive Care Unit (NICU)

Objectives

Aim of the present study was to analyse, if there is an age-dependency of parental stress after birth of a preterm neonate admitted to NICU and if there is a difference between mothers and fathers.

Methods

A prospective observational study was conducted at the NICU, Medical University of Graz, Austria. 50 mothers and 50 fathers received the PSS:NICU questionnaire within 72 hours after preterm birth of their neonate, which has been admitted to the NICU immediately after birth. This questionnaire measures parental stress via the three subscales “Looks and Behave of the Child”, “Parental Role Alteration” and “Sights and Sounds”. For analyses age of mothers and fathers were correlated to values obtained from the subscales of the PSS:NICU.

Results

47 mothers (age 30.5±5 years) and 47 fathers (age 33±6 years) were included for analyses. There was a significant increase in the stress subscale “Looks and Behave of the child” with increasing age of the mother, whereby “Parental Role Alteration” and “Sights and sounds” did not show a significant correlation with maternal age. No significant correlations of age of the father with any subscale of the PSS:NICU were observed.

Conclusion

Age-dependency of stress experience after preterm birth differs between mothers and fathers. This observation should to be taken into account when supporting mothers and fathers of preterm neonates admitted to NICU.

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