title: aEEG and NIRS during transition and resuscitation after birth: promising additional tools; an observational study.
abstract: OBJECTIVE
  During resuscitation no routine cerebral monitoring is available. We aimed at monitoring cerebral activity and oxygenation continuously during neonatal transition and resuscitation.
  
  
  METHODS
  Neonates ≥34 weeks of gestation born via cesarean section were included. Cerebral activity was continuously measured with amplitude-integrated-EEG (aEEG) and cerebral oxygenation (rSO2) with near-infrared-spectroscopy (NIRS) during the first 10 min after birth. For quantitative analysis of aEEG every minute the mean minimum amplitude (V(min)) and maximum amplitude (V(max)) was determined. Uncompromised neonates were compared to neonates in need of resuscitation.
  
  
  RESULTS
  Out of 224 eligible neonates 31 uncompromised and 15 in need of respiratory support were included. Uncompromised neonates showed higher values for V(min) in the third minute and higher values for V(max) in the third and fourth minute compared to the tenth minute post-partum. In uncompromised neonates rSO2 values during the first 6 min after birth were lower compared to minute ten. Neonates in need of respiratory support had lower rSO2 values over the first 8 min after birth compared to minute ten.
  
  
  CONCLUSIONS
  This is the first study demonstrating that monitoring of aEEG and NIRS to measure cerebral activity and oxygenation during immediate postpartum transition is feasible. During transition compromised neonates requiring resuscitation showed a different cerebral activity pattern compared to uncompromised neonates.
authors: Research Unit for Cerebral Development and Oximetry, Division of Neonatology, Department of Pediatrics, Medical University of Graz, Austria. pichler.gerhard@klinikum-graz.at
authors: Gerhard
authors: G
authors: Pichler
authors: Alexander
authors: A
authors: Avian
authors: Corinna
authors: C
authors: Binder
authors: Heinz
authors: H
authors: Zotter
authors: Georg Marcus
authors: GM
authors: Schmölzer
authors: Nicholas
authors: N
authors: Morris
authors: Wilhelm
authors: W
authors: Müller
authors: Berndt
authors: B
authors: Urlesberger
mesh_terms: D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000502:physiology; D002585:Cesarean Section; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010100:Oxygen / Q000097:blood; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen