Near-infrared spectroscopy monitoring during immediate transition after birth: time to obtain cerebral tissue oxygenation

Feasibility of cerebral tissue oxygenation measurements immediately after birth has been published starting with first values 2 min after birth. Aim of this study was to evaluate, the time periods from birth and from arrival at the resuscitation table to obtain the first cerebral tissue oxygenation values with two different near infrared spectroscopy (NIRS) devices. The present study is an analysis of exploratory parameters of two prospective observational studies. Cerebral tissue oxygen saturation was measured by the NIRO 200NX measuring "cerebral-tissue-oxygenation-index" (cTOI) or the INVOS5100C measuring "cerebral-regional-oxygen-saturation" (crSO(2)). Four time periods (T) were defined: T1 birth to arrival at resuscitation table, T2 arrival to application of NIRS sensor, T3 application to first displayed cTOI or crSO(2) value, and T4 from arrival at resuscitation table to first displayed values. Additionally, we compared first displayed values of cTOI and crSO(2). Thirty neonates were included. Twenty-four were term and six late-preterm neonates. Fifteen neonates measured with NIRO were compared to 15 measured with INVOS. T1 was 49 (6-163) s with NIRO versus 59 (15-87) s with INVOS, T2 14 (4-20) s versus 12 (15-18) s, T3 33 (13-138) s versus 17 (6-290) s and T4 46 (20-153) s and 34 (14-300) s. The first displayed value tended to be higher for cTOI [54% (18-80)] compared to crSO(2) [35% (15-87)]. There were no significant differences between devices in time periods and first values displayed. Cerebral tissue oxygenation can be measured within 1 min after arriving at the resuscitation table in term and preterm neonates after birth without difference between devices.