title: A left-to-right shunt via the ductus arteriosus is associated with increased regional cerebral oxygen saturation during neonatal transition.
abstract: BACKGROUND
  Oxygen delivery to the brain is dependent on cardiac output and arterial oxygen content.
  
  
  OBJECTIVE
  The study was designed to investigate the influence of a left-to-right shunt via the ductus arteriosus (DA) on regional oxygen saturation (rSO2) of the brain and peripheral tissue during postnatal transition.
  
  
  METHODS
  Nested case-control study. In term neonates after elective cesarian section, rSO2 of the brain and pre- and postductal peripheral tissue were measured 15 min after uncomplicated postnatal transition. Two groups were formed according to shunt flow characteristics via the DA: shunt group (with a left-to-right shunt), and nonshunt group (no shunt).
  
  
  RESULTS
  Of 80 infants, in 58 (72%) a left-to-right shunt was identified, and in 22 (28%) no flow was seen via the DA. The 22 infants formed the nonshunt group. They were matched with 22 newborn infants with a left-to-right shunt via the DA (shunt group). Infants in the nonshunt group had significantly lower cerebral rSO2 values and higher fractional tissue oxygen extraction and heart rate values. There were no significant differences in regard to peripheral rSO2 values.
  
  
  CONCLUSIONS
  During postnatal transition, term infants with a left-to-right shunt via the DA have significantly higher cerebral rSO2 values compared to infants without shunt flow.
authors: Research Unit for Cerebral Development and Oximetry, Division of Neonatology, Medical University of Graz, Graz, Austria. berndt.urlesberger@medunigraz.at
authors: Berndt
authors: B
authors: Urlesberger
authors: Anna
authors: A
authors: Brandner
authors: Mirjam
authors: M
authors: Pocivalnik
authors: Martin
authors: M
authors: Koestenberger
authors: Nicholas
authors: N
authors: Morris
authors: Gerhard
authors: G
authors: Pichler
mesh_terms: D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002302:Cardiac Output; D016022:Case-Control Studies; D002560:Cerebrovascular Circulation; D002585:Cesarean Section; D004373:Ductus Arteriosus / Q000502:physiology*; D017558:Elective Surgical Procedures; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors
chemical_list: D015415:Biomarkers; D010100:Oxygen