Cerebral oxygenation after birth - a comparison of INVOS(®) and FORE-SIGHT™ near-infrared spectroscopy oximeters.
OBJECTIVE
To compare absolute values of regional cerebral tissue oxygenation (cStO2 ) during haemodynamic transition after birth and repeatability during steady state for two commercial near-infrared spectroscopy (NIRS) devices.


METHODS
In a prospective observational study, the INVOS 5100C and FORE-SIGHT were compared on 12 term newborns delivered by elective caesarean section. During the 10 min following umbilical cord clamping, cStO2 was measured simultaneously with the neonatal sensors from each device. Repeated measurements were taken the following day.


RESULTS
Three and 8 min after clamping, the mean cStO2 value increased from 53.4% (CI 36.8-69.9%) to 86.0% (CI 80.2-91.7%) for INVOS and from 61.6% (CI 55.4-67.8%) to 82.2% (CI 77.7-86.7%) for FORE-SIGHT. The Bland-Altman plot revealed decreasing difference (INVOS minus FORE-SIGHT) (D) in absolute values (A) with increasing cStO2 (D = 0.5A - 38.19 p = <0.001). The mean steady-state value on day two was 78.4% (CI 74.6-82.2%) and 86.2% (CI 85.0-87.4%) for INVOS and FORE-SIGHT, respectively. The within-subject standard deviation during steady-state repeated measurements was 4.8% ± 0.86 for INVOS and 2.8% ± 0.5 for FORE-SIGHT.


CONCLUSIONS
The INVOS and FORE-SIGHT cStO2 estimates showed oxygenation-level-dependent difference during birth transition. The better repeatability of FORE-SIGHT could be due to the lower response to change in saturation.
Department of Neonatology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Trine W
TW
Hessel
Simon
S
Hyttel-Sorensen
Gorm
G
Greisen
D001921:Brain / Q000098:blood supply*; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010092:Oximetry / Q000295:instrumentation* / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation*
Cerebral oxygenation; Near-infrared spectroscopy; Newborn; Transition