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      Cerebral and peripheral tissue oxygenation in stable neonates: Absent influence of cardiac function

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          Abstract

          Aim

          Cardiac function is a major factor for tissue perfusion and therefore may affect the tissue oxygen saturation. Aim was to analyse possible associations between cardiac function parameters and cerebral and peripheral tissue oxygenation in neonates on the first day after birth.

          Methods

          For the present study, we analysed secondary outcome parameters of a previously performed prospective single centre observational study. The prospective study was conducted at the Medical University of Graz, Austria between September 2011 and June 2013. We included preterm and term neonates who were admitted to the neonatal intensive care unit and in whom simultaneous near‐infrared spectroscopy measurements and echocardiography were obtained on the first day after birth. Cardiac function parameters were correlated to cerebral and peripheral tissue oxygen saturation and cerebral and peripheral fractional tissue oxygen extraction at the time of echocardiography.

          Results

          A total of 60 neonates of whom 47 were preterm and 13 were term (median gestational age: 34; IQR 33‐35 weeks, mean birth weight: 2276 ± 774 grams) were included. There were no statistically significant correlations between cardiac function parameters and regional tissue oxygenation parameters.

          Conclusion

          In the present study, we found no correlation between regional tissue oxygenation and parameters of cardiac function in cardio‐circulatory stable neonates on the first day after birth.

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          Most cited references27

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          Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms.

          We have presented recommendations for the optimum acquisition of quantitative two-dimensional data in the current echocardiographic environment. It is likely that advances in imaging may enhance or supplement these approaches. For example, three-dimensional reconstruction methods may greatly augment the accuracy of volume determination if they become more efficient. The development of three-dimensional methods will depend in turn on vastly improved transthoracic resolution similar to that now obtainable by transesophageal echocardiography. Better resolution will also make the use of more direct methods of measuring myocardial mass practical. For example, if the epicardium were well resolved in the long-axis apical views, the myocardial shell volume could be measured directly by the biplane method of discs rather than extrapolating myocardial thickness from a single short-axis view. At present, it is our opinion that current technology justifies the clinical use of the quantitative two-dimensional methods described in this article. When technically feasible, and if resources permit, we recommend the routine reporting of left ventricular ejection fraction, diastolic volume, mass, and wall motion score.
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            Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters.

            The relatively good transparency of biological materials in the near infrared region of the spectrum permits sufficient photon transmission through organs in situ for the monitoring of cellular events. Observations by infrared transillumination in the exposed heart and in the brain in cephalo without surgical intervention show that oxygen sufficiency for cytochrome a,a3, function, changes in tissue blood volume, and the average hemoglobin-oxyhemoglobin equilibrium can be recorded effectively and in continuous fashion for research and clinical purposes. The copper atom associated with heme a3 did not respond to anoxia and may be reduced under normoxic conditions, whereas the heme-a copper was at least partially reducible.
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              • Article: not found

              Cerebral oxygenation, extraction, and autoregulation in very preterm infants who develop peri-intraventricular hemorrhage.

              To test the hypothesis that near-infrared spectroscopy (NIRS)-determined patterns of regional cerebral oxygen saturation (rScO2), cerebral fractional tissue oxygen extraction (cFTOE), and autoregulatory ability can identify neonates at risk for developing peri-intraventricular hemorrhage (PIVH).
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                Author and article information

                Contributors
                corinna.binder@medunigraz.at
                Journal
                Acta Paediatr
                Acta Paediatr
                10.1111/(ISSN)1651-2227
                APA
                Acta Paediatrica (Oslo, Norway : 1992)
                John Wiley and Sons Inc. (Hoboken )
                0803-5253
                1651-2227
                28 January 2020
                August 2020
                : 109
                : 8 ( doiID: 10.1111/apa.v109.8 )
                : 1560-1569
                Affiliations
                [ 1 ] Research Unit for Neonatal Micro‐ and Macrocirculation Department of Pediatrics and Adolescent Medicine Medical University of Graz Graz Austria
                [ 2 ] Division of Neonatology Department of Pediatrics and Adolescent Medicine Medical University of Graz Graz Austria
                [ 3 ] Division of Pediatric Cardiology Department of Paediatrics and Adolescent Medicine Medical University of Graz Graz Austria
                [ 4 ] Institute for Medical Informatics, Statistics and Documentation Medical University of Graz Graz Austria
                Author notes
                [*] [* ] Correspondence

                Corinna Binder‐Heschl, Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 34/2, 8036 Graz, Austria.

                Email: corinna.binder@ 123456medunigraz.at

                Author information
                https://orcid.org/0000-0003-3429-7597
                https://orcid.org/0000-0003-2405-7143
                Article
                APA15172
                10.1111/apa.15172
                7383825
                31943338
                0460268b-e1fb-4e39-be13-c1701c084a07
                © 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 01 October 2019
                : 02 January 2020
                : 10 January 2020
                Page count
                Figures: 4, Tables: 2, Pages: 10, Words: 4694
                Categories
                Regular Article
                Regular Articles
                Neonatology
                Custom metadata
                2.0
                August 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.6 mode:remove_FC converted:27.07.2020

                Pediatrics
                cardiac function,echocardiography,near‐infrared spectroscopy,neonate,tissue oxygenation

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