title: The influence of perinatal asphyxia on peripheral oxygenation and perfusion in neonates.
abstract: BACKGROUND
  Perinatal asphyxia influences peripheral oxygenation and perfusion in neonates.
  
  
  OBJECTIVE
  The aim was to investigate the influence of perinatal asphyxia on peripheral oxygenation and perfusion in neonates by using near-infrared spectroscopy (NIRS).
  
  
  METHODS
  Prospective observational study. Neonates with gestational age >34 weeks and birth weight >2000 g without infection or congenital malformations were included. Peripheral muscle NIRS measurements in combination with venous occlusion were performed once in the first 48 h of life. Tissue oxygenation index (TOI), mixed venous oxygenation (SvO2), fractional oxygen extraction (FOE), haemoglobin flow (Hbflow), oxygen delivery (DO2) and oxygen consumption (VO2) were assessed. Furthermore arterial oxygen saturation, heart rate, blood pressure and temperatures were measured. Neonates with a UapH≤7.15 and an Apgar 5≤6 were compared to neonates with a UapH≥7.15, an Apgar 5≥7 (control group) and a UapH was correlated to NIRS parameters.
  
  
  RESULTS
  8 asphyxiated neonates were compared to 30 neonates in the control group. TOI (67.7±5.5%) and DO2 (29.0±14.2 μmol/100 mL/min) were significantly lower in asphyxiated neonates compared to the controls (TOI 71.8±4.9%, p=0.045; DO2 43.9±16.9 μmol/100 mL/min, p=0.028) and FOE was significantly higher (0.33±0.05) compared to the controls (0.28±0.06, p=0.028). Furthermore significant correlations between UapH and DO2 (r=0.78, p=0.022), VO2 (r=0.80, p=0.018) and FOE (r=-0.75, p=0.034) in the asphyxiated group were found.
  
  
  CONCLUSIONS
  Peripheral oxygenation and perfusion measured with NIRS are compromised in neonates with perinatal asphyxia with worsening of parameters and degree of acidosis in the umbilical cord blood.
authors.affiliation: Division of Neonatology, Department of Paediatrics, Medical University of Graz, Austria.
authors.forename: Nina
authors.initials: N
authors.lastname: Tax
authors.forename: Berndt
authors.initials: B
authors.lastname: Urlesberger
authors.forename: Corinna
authors.initials: C
authors.lastname: Binder
authors.forename: Mirjam
authors.initials: M
authors.lastname: Pocivalnik
authors.forename: Nicholas
authors.initials: N
authors.lastname: Morris
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pichler
mesh_terms: D001238:Asphyxia Neonatorum / Q000503:physiopathology* / Q000628:therapy; D016022:Case-Control Studies; D005121:Extremities / Q000098:blood supply; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D010477:Perfusion; D011446:Prospective Studies; D012039:Regional Blood Flow
chemical_list: D010100:Oxygen