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

Objective: To investigate if preterm neonates with arterial oxygen saturation (SpO(2))<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO(2)), compared to infants reaching the target. Methods: 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(2) and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO(2) ≥ 80% (“≥80% group”) and those with a 5-min SpO(2) < 80% (“<80% group”). Groups were compared regarding rcStO(2), SpO(2), and HR. Furthermore, we analyzed whether a 5-min SpO(2) < 80% was associated with a rcStO(2) below the 10th percentile at the same time point. Results: 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(2) (p < 0.001). Furthermore, 80.3% of neonates in the “ <80% group” and 23.4% in the “≥80% group” had rcStO(2) values below the 10th percentile at 5 min (p < 0.001). HR was significantly lower at minute 3 and 4 in the “ <80% group” (p < 0.002). Conclusion: Preterm infants needing respiratory support, who do not reach the SpO(2) target of 80% at 5 min after birth, show significantly diminished rcStO(2) values compared to neonates reaching the target.