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Lung ultrasound makes use of artifacts generated by the ratio of air and fluid in the lung. Recently, an enormous increase of research regarding lung ultrasound emerged, especially in intensive care units. The use of lung ultrasound on the neonatal intensive care unit enables the clinician to gain knowledge about the respiratory condition of the patients, make quick decisions, and reduces exposure to ionizing radiation. In this narrative review, the possibilities of lung ultrasound for the stabilization and resuscitation of the neonate using the ABCDE algorithm will be discussed.
Lukas Aichhorn; Erik Küng; Lisa Habrina; Tobias Werther; Angelika Berger; Berndt Urlesberger; Bernhard Schwaberger. The Role of Lung Ultrasound in the Management of the Critically Ill Neonate—A Narrative Review and Practical Guide. Children 2021, 8, 628 .
AMA StyleLukas Aichhorn, Erik Küng, Lisa Habrina, Tobias Werther, Angelika Berger, Berndt Urlesberger, Bernhard Schwaberger. The Role of Lung Ultrasound in the Management of the Critically Ill Neonate—A Narrative Review and Practical Guide. Children. 2021; 8 (8):628.
Chicago/Turabian StyleLukas Aichhorn; Erik Küng; Lisa Habrina; Tobias Werther; Angelika Berger; Berndt Urlesberger; Bernhard Schwaberger. 2021. "The Role of Lung Ultrasound in the Management of the Critically Ill Neonate—A Narrative Review and Practical Guide." Children 8, no. 8: 628.
Severe desaturation or bradycardia often occur during neonatal endotracheal intubation. Using continuous gas flow through the endotracheal tube might reduce the incidence of these events. We hypothesized that continuous gas flow through the endotracheal tube during nasotracheal intubation compared to standard nasotracheal intubation will reduce the number of intubation attempts in newborn infants. In a randomized controlled pilot study, neonates were either intubated with continuous gas flow through the endotracheal tube during intubation (intervention group) or no gas flow during intubation (control group). Recruitment was stopped early due to financial and organizational issues. A total of 16 infants and 39 intubation attempts were analyzed. The median (interquartile range) number of intubation attempts and number of abandoned intubations due to desaturation and/or bradycardia were 1 (1–2) and 4 (2–5), (p = 0.056) and n = 3 versus n = 20, (p = 0.060) in the intervention group and control group, respectively. Continuous gas flow through the endotracheal tube during intubation seems to be favorable and there are no major unexpected adverse consequences of attempting this methodology.
Marlies Bruckner; Nicholas Morris; Gerhard Pichler; Christina Wolfsberger; Stefan Heschl; Lukas Mileder; Bernhard Schwaberger; Georg Schmölzer; Berndt Urlesberger. In Newborn Infants a New Intubation Method May Reduce the Number of Intubation Attempts: A Randomized Pilot Study. Children 2021, 8, 553 .
AMA StyleMarlies Bruckner, Nicholas Morris, Gerhard Pichler, Christina Wolfsberger, Stefan Heschl, Lukas Mileder, Bernhard Schwaberger, Georg Schmölzer, Berndt Urlesberger. In Newborn Infants a New Intubation Method May Reduce the Number of Intubation Attempts: A Randomized Pilot Study. Children. 2021; 8 (7):553.
Chicago/Turabian StyleMarlies Bruckner; Nicholas Morris; Gerhard Pichler; Christina Wolfsberger; Stefan Heschl; Lukas Mileder; Bernhard Schwaberger; Georg Schmölzer; Berndt Urlesberger. 2021. "In Newborn Infants a New Intubation Method May Reduce the Number of Intubation Attempts: A Randomized Pilot Study." Children 8, no. 7: 553.
The immediate transition from foetus to neonate includes substantial changes, especially concerning the cardiovascular system. Furthermore, the brain is one of the most vulnerable organs to hypoxia during this period. According to current guidelines for postnatal stabilization, the recommended parameters for monitoring are heart rate (HR) and arterial oxygen saturation (SpO2). Recently, there is a growing interest in advanced monitoring of the cardio-circulatory system and the brain to get further objective information about the neonate’s condition during the immediate postnatal transition after birth. The aim of the present study was to combine cardiac output (CO) and brain oxygenation monitoring in term neonates after caesarean section in order to analyse the potential influence of CO on cerebral oxygenation during neonatal transition. This was a monocentric, prospective, observational study. For non-invasive cardiac output measurements, the electrical velocimetry (EV) method (Aesculon Monitor, Osypka Medical, CA, USA) was used. The pulse oximeter probe for SpO2 and HR measurements was placed on the right hand or wrist. The cerebral tissue oxygen index (cTOI) was measured using a NIRO-200NX monitor with the near-infrared spectroscopy (NIRS) transducer on the right frontoparietal head. Monitoring started at minute 1 and was continued until minute 15 after birth. At minutes 5, 10, and 15 after birth, mean CO was calculated from six 10 s periods (with beat-to-beat analysis). During the study period, 99 term neonates were enrolled. Data from neonates with uncomplicated transitions were analysed. CO showed a tendency to decrease until minute 10. During the complete observational period, there was no significant correlation between CO and cTOI. The present study was the first to investigate a possible correlation between CO and cerebral oxygenation in term infants during the immediate neonatal transition. In term infants with uncomplicated neonatal transition after caesarean section, CO did not correlate with cerebral oxygenation.
Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Nina Höller; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. Cardiac Output and Cerebral Oxygenation in Term Neonates during Neonatal Transition. Children 2021, 8, 439 .
AMA StyleNariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Nina Höller, Alexander Avian, Berndt Urlesberger, Gerhard Pichler. Cardiac Output and Cerebral Oxygenation in Term Neonates during Neonatal Transition. Children. 2021; 8 (6):439.
Chicago/Turabian StyleNariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Nina Höller; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. 2021. "Cardiac Output and Cerebral Oxygenation in Term Neonates during Neonatal Transition." Children 8, no. 6: 439.
An asphyxiated term neonate required postnatal resuscitation. After six minutes of cardio-pulmonary resuscitation (CPR) and two doses of epinephrine, spontaneous circulation returned, but was shortly followed by ventricular fibrillation. CPR and administration of magnesium, calcium gluconate, and sodium bicarbonate did not improve the neonate’s condition. A counter shock of five Joule was delivered and the cardiac rhythm immediately converted to sinus rhythm. The neonate was transferred to the neonatal intensive care unit and received post-resuscitation care. Due to prolonged QTc and subsequently suspected long-QT syndrome propranolol treatment was initiated. The neonate was discharged home on day 14 without neurological sequelae.
Lukas Mileder; Nicholas Morris; Stefan Kurath-Koller; Jasmin Pansy; Gerhard Pichler; Mirjam Pocivalnik; Bernhard Schwaberger; Ante Burmas; Berndt Urlesberger. Successful Postnatal Cardiopulmonary Resuscitation Due to Defibrillation. Children 2021, 8, 421 .
AMA StyleLukas Mileder, Nicholas Morris, Stefan Kurath-Koller, Jasmin Pansy, Gerhard Pichler, Mirjam Pocivalnik, Bernhard Schwaberger, Ante Burmas, Berndt Urlesberger. Successful Postnatal Cardiopulmonary Resuscitation Due to Defibrillation. Children. 2021; 8 (5):421.
Chicago/Turabian StyleLukas Mileder; Nicholas Morris; Stefan Kurath-Koller; Jasmin Pansy; Gerhard Pichler; Mirjam Pocivalnik; Bernhard Schwaberger; Ante Burmas; Berndt Urlesberger. 2021. "Successful Postnatal Cardiopulmonary Resuscitation Due to Defibrillation." Children 8, no. 5: 421.
Continuous monitoring of arterial oxygen saturation by pulse oximetry (SpO2) is the main method to guide respiratory and oxygen support in neonates during postnatal stabilization and after admission to neonatal intensive care unit. The accuracy of these devices is therefore crucial. The presence of fetal hemoglobin (HbF) in neonatal blood might affect SpO2 readings. We performed a systematic qualitative review to investigate the impact of HbF on SpO2 accuracy in neonates. PubMed/Medline, Embase, Cumulative Index to Nursing & Allied Health database (CINAHL) and Cochrane library databases were searched from inception to January 2021 for human studies in the English language, which compared arterial oxygen saturations (SaO2) from neonatal blood with SpO2 readings and included HbF measurements in their reports. Ten observational studies were included. Eight studies reported SpO2-SaO2 bias that ranged from −3.6%, standard deviation (SD) 2.3%, to +4.2% (SD 2.4). However, it remains unclear to what extent this depends on HbF. Five studies showed that an increase in HbF changes the relation of partial oxygen pressure (paO2) to SpO2, which is physiologically explained by the leftward shift in oxygen dissociation curve. It is important to be aware of this shift when treating a neonate, especially for the lower SpO2 limits in preterm neonates to avoid undetected hypoxia.
Ena Pritišanac; Berndt Urlesberger; Bernhard Schwaberger; Gerhard Pichler. Accuracy of Pulse Oximetry in the Presence of Fetal Hemoglobin—A Systematic Review. Children 2021, 8, 361 .
AMA StyleEna Pritišanac, Berndt Urlesberger, Bernhard Schwaberger, Gerhard Pichler. Accuracy of Pulse Oximetry in the Presence of Fetal Hemoglobin—A Systematic Review. Children. 2021; 8 (5):361.
Chicago/Turabian StyleEna Pritišanac; Berndt Urlesberger; Bernhard Schwaberger; Gerhard Pichler. 2021. "Accuracy of Pulse Oximetry in the Presence of Fetal Hemoglobin—A Systematic Review." Children 8, no. 5: 361.
Body temperature (BT) management remains a challenge in neonatal intensive care, especially during resuscitation after birth. Our aim is to analyze whether there is an association between the BT and cerebral and peripheral tissue oxygen saturation (crSO2/cTOI and prSO2), arterial oxygen saturation (SpO2), and heart rate (HR). The secondary outcome parameters of five prospective observational studies are analyzed. We include preterm and term neonates born by Caesarean section who received continuous pulse oximetry and near-infrared spectroscopy monitoring during the first 15 min, and a rectal BT measurement once in minute 15 after birth. Four-hundred seventeen term and 169 preterm neonates are included. The BT did not correlate with crSO2/cTOI and SpO2. The BT correlated with the HR in all neonates (ρ = 0.210, p < 0.001) and with prSO2 only in preterm neonates (ρ = −0.285, p = 0.020). The BT was lower in preterm compared to term infants (36.7 [36.4–37.0] vs. 36.8 [36.6–37.0], p = 0.001) and prevalence of hypothermia was higher in preterm neonates (29.5% vs. 12.0%, p < 0.001). To conclude, the BT did not correlate with SpO2 and crSO2/cTOI, however, there was a weak positive correlation between the BT and the HR in the whole cohort and a weak correlation between the BT and prSO2 only in preterm infants. Preterm neonates had a statistically lower BT and suffered significantly more often from hypothermia during postnatal transition.
Marlies Bruckner; Lukas P. Mileder; Alisa Richter; Nariae Baik-Schneditz; Bernhard Schwaberger; Corinna Binder-Heschl; Berndt Urlesberger; Gerhard Pichler. Association between Regional Tissue Oxygenation and Body Temperature in Term and Preterm Infants Born by Caesarean Section. Children 2020, 7, 205 .
AMA StyleMarlies Bruckner, Lukas P. Mileder, Alisa Richter, Nariae Baik-Schneditz, Bernhard Schwaberger, Corinna Binder-Heschl, Berndt Urlesberger, Gerhard Pichler. Association between Regional Tissue Oxygenation and Body Temperature in Term and Preterm Infants Born by Caesarean Section. Children. 2020; 7 (11):205.
Chicago/Turabian StyleMarlies Bruckner; Lukas P. Mileder; Alisa Richter; Nariae Baik-Schneditz; Bernhard Schwaberger; Corinna Binder-Heschl; Berndt Urlesberger; Gerhard Pichler. 2020. "Association between Regional Tissue Oxygenation and Body Temperature in Term and Preterm Infants Born by Caesarean Section." Children 7, no. 11: 205.
Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition in preterm neonates. The secondary aim was to analyze the potential influence of FIRS on cerebral injury and mortality. Methods: Secondary outcome parameters of prospective observational studies were analyzed. Preterm neonates with measured IL-6 values from umbilical cord blood and cerebral near-infrared spectroscopy (NIRS) measurements during immediate transition after birth were included. Preterm neonates with FIRS (FIRS group) were matched 1:1 for gestational age (± 1 week) to preterm neonates without FIRS (non-FIRS group). crSO2, cFTOE, arterial oxygen saturation (SpO2), heart rate (HR), and fraction of inspired oxygen (FiO2) were compared between both groups. In addition, cerebral injury and mortality were compared between both groups. Results: A total of 46 preterm neonates were included. Twenty-three neonates in the FIRS group [median gestational age 32.1 (IQR 30.3-33.0) weeks; median IL-6 19.7 (IQR 12.2-37.0) pg/ml] were compared to 23 neonates in the non-FIRS group [gestational age: 32.0 (30.4-33.1) weeks; IL-6: 5.4 (3.0-6.7) pg/ml]. cFTOE showed significantly lower values within the first 4 min and a trend toward lower values in minute 5 after birth in the FIRS group. There were no significant differences in crSO2 within the first 15 min after birth between the two groups. SpO2 was significantly lower in minutes 5 and 6 and HR was significantly lower in minutes 2 and 4 after birth in the FIRS group compared to the non-FIRS group. Survival without cerebral injury was similar in both groups. Conclusion: In preterm neonates with FIRS the crSO2 was similar despite significantly lower cFTOE values during the first minutes after birth. This observation may be a result of compromised oxygen consumption and delivery in the first minutes after birth in neonates with FIRS.
Christina Helene Wolfsberger; Marlies Bruckner; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Peter Mileder; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates. Frontiers in Pediatrics 2020, 8, 401 .
AMA StyleChristina Helene Wolfsberger, Marlies Bruckner, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Peter Mileder, Alexander Avian, Berndt Urlesberger, Gerhard Pichler. Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates. Frontiers in Pediatrics. 2020; 8 ():401.
Chicago/Turabian StyleChristina Helene Wolfsberger; Marlies Bruckner; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Peter Mileder; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. 2020. "Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates." Frontiers in Pediatrics 8, no. : 401.
Background: Intrauterine growth restriction (IUGR) is associated with adverse perinatal outcome. Affected fetuses commonly display typical blood flow redistribution towards the brain (“brain sparing”). Accordingly, increased cerebral oxygen saturation has been observed in IUGR neonates within the first days of life. Aim: The aim of our study was to assess cerebral oxygenation behavior during immediate neonatal transition in IUGR infants. Methods: This is a retrospective single-center observational cohort study. Cerebral regional oxygen saturation (crSO2) was measured with near-infrared spectroscopy in neonates during the first 15 min after birth. Neonates with IUGR (IUGR group) were matched for gestational age (±1 week) and gender with neonates that were appropriate for gestational age (AGA). The AGA:IUGR matching ratio was 3:1. Arterial oxygen saturation (SpO2), heart rate (HR), crSO2, and cerebral fractional tissue oxygen extraction (cFTOE) were compared between the groups. Results: Between August 2010 and October 2017, 45 neonates with IUGR were identified and matched to 135 AGA neonates. Mean gestational age was 33.1 ± 3.0 weeks in the IUGR group and 33.5 ± 2.7 weeks in the AGA group. Mean birth weight was 1,559 ± 582 g in the IUGR group and 2,051 ± 679 g in the AGA group. There was a significant group difference in crSO2 beginning at 5 min and continuing for the rest of the observation time with higher crSO2 values in the IUGR group (main effect group: p = 0.011; interaction time × group: p = 0.039). In cFTOE, a significant difference could be observed at 5–9 and 11–13 min with lower rates of oxygen extraction in the IUGR group (main effect group: p = 0.025; interaction time × group: p = 0.463). Concerning SpO2 and HR, there was no significant difference between the IUGR and the AGA neonates. Conclusion: Neonates of the IUGR group did show significantly higher crSO2 values and significantly lower cFTOE values already during immediate neonatal transition compared to the AGA group.
Nariae Baik-Schneditz; Gerhard Pichler; Bernhard Schwaberger; Corinna Binder-Heschl; Lukas Mileder; Irwin K.H. Reiss; Alexander Avian; Patrick Greimel; Philipp Klaritsch; Berndt Urlesberger. Effect of Intrauterine Growth Restriction on Cerebral Regional Oxygen Saturation in Preterm and Term Neonates during Immediate Postnatal Transition. Neonatology 2020, 117, 1 -7.
AMA StyleNariae Baik-Schneditz, Gerhard Pichler, Bernhard Schwaberger, Corinna Binder-Heschl, Lukas Mileder, Irwin K.H. Reiss, Alexander Avian, Patrick Greimel, Philipp Klaritsch, Berndt Urlesberger. Effect of Intrauterine Growth Restriction on Cerebral Regional Oxygen Saturation in Preterm and Term Neonates during Immediate Postnatal Transition. Neonatology. 2020; 117 (3):1-7.
Chicago/Turabian StyleNariae Baik-Schneditz; Gerhard Pichler; Bernhard Schwaberger; Corinna Binder-Heschl; Lukas Mileder; Irwin K.H. Reiss; Alexander Avian; Patrick Greimel; Philipp Klaritsch; Berndt Urlesberger. 2020. "Effect of Intrauterine Growth Restriction on Cerebral Regional Oxygen Saturation in Preterm and Term Neonates during Immediate Postnatal Transition." Neonatology 117, no. 3: 1-7.
Background: Near-infrared spectroscopy (NIRS) combined with venous occlusions enables peripheral-muscle oxygenation and perfusion monitoring. Aim of the present exploratory observational study was to evaluate peripheral-muscle oxygenation and perfusion during the first 24 hours after birth in stable preterm neonates. Methods: Secondary outcome parameters of prospective observational studies were analysed. Preterm neonates with peripheral-muscle NIRS measurements combined with venous occlusion on the first day after birth were included. Neonates without circulatory support and without signs of infection/inflammation were included. Neonates were stratified in four groups according to their measurement time-point (6-hour-periods) and matched 2:1 for gestational age ±1 week. For each group haemoglobin flow (Hbflow), oxygen-delivery (DO2), oxygen-consumption (VO2), fractional-oxygen-extraction (FOE), tissue-oxygenation-index (TOI) and mixed-venous-oxygenation (SvO2) were calculated. Neonates with measurements during the first 6-hour time period were compared to neonates with measurements of the following time periods. Results: 40 preterm neonates (gestational age (median(IQR)): 33.5(32.5-34.1)weeks) measured during the first 6-hour period after birth were compared to 20 preterm neonates measured in each of the following 6-hour periods (period two: 33.7(33.1-34.3)weeks; period three: 34.1(33.2-34.6)weeks; period four: 33.8(32.6-34.6)weeks). Hbflow, DO2 and SvO2 were significantly higher in the second and third 6-hour time period compared to the first 6-hour period. VO2 did not change significantly during the first day after birth. FOE was significantly lower in the second, third and fourth time period compared to the first 6-hour period. TOI showed a non-significant trend towards higher values in the third period compared to the first 6-hour period. Conclusion: In preterm neonates Hbflow, DO2, SvO2 increased, FOE decreased and TOI showed a trend towards increase during the first day after birth, whereas VO2 did not change. Changes of peripheral-muscle oxygenation during the first day after birth in stable preterm neonates are different to already published changes thereafter.
Christina Helene Wolfsberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Corinna Binder-Heschl; Höller Nina; Lukas Peter Mileder; Marlies Bruckner; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. Changes in peripheral muscle oxygenation measured with near-infrared spectroscopy in preterm neonates within the first 24 h after birth. Physiological Measurement 2020, 41, 075003 .
AMA StyleChristina Helene Wolfsberger, Nariae Baik-Schneditz, Bernhard Schwaberger, Corinna Binder-Heschl, Höller Nina, Lukas Peter Mileder, Marlies Bruckner, Alexander Avian, Berndt Urlesberger, Gerhard Pichler. Changes in peripheral muscle oxygenation measured with near-infrared spectroscopy in preterm neonates within the first 24 h after birth. Physiological Measurement. 2020; 41 (7):075003.
Chicago/Turabian StyleChristina Helene Wolfsberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Corinna Binder-Heschl; Höller Nina; Lukas Peter Mileder; Marlies Bruckner; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. 2020. "Changes in peripheral muscle oxygenation measured with near-infrared spectroscopy in preterm neonates within the first 24 h after birth." Physiological Measurement 41, no. 7: 075003.
Objective To investigate, if there is an association between the Resistance Index (RI) in anterior cerebral artery (ACA), a parameter of cerebral perfusion, and regional cerebral oxygenation (cTOI) in preterm infants within the first 24 hours after birth. Methods Post‐hoc analysis of data of a prospective randomised controlled trial “Avoiding Hypotension in Preterm Infants” (ClinicalTrials.gov identifier: NCT01910467). cTOI was measured using near‐infrared spectroscopy (NIRS) (NIRO‐200NX, Hamamatsu, Japan). The NIRS sensor was placed on the left forehead within six hours after birth and cTOI was measured continuously for 24 hours. Peripheral arterial oxygen saturation (SpO2) and heart rate (HR) were continuously measured by pulse oximetry. During the first 24 hours after birth a cranial ultrasound was routinely performed by a neonatologist in each preterm infant including measurement of RI in the ACA. For analyses RI was correlated to cTOI, SpO2, and HR. Result Between October 2013 and December 2016, 108 preterm infants with mean (SD) gestational age and birth weight of 32.7 (1.9) weeks and 1845 (485) g were included into the trial and cranial ultrasound data of 80 preterm infants were available and analysed in the present study. There was a statistically significant negative correlation between RI and cTOI (p=0.0001 / ρ=‐0.438). RI did neither correlate with SpO2 nor with HR. Conclusion In preterm infants during the first 24 hours after birth: increasing RI values were associated with lower cTOI values in preterm infants.
Nariae Baik‐Schneditz; Nina Höller; Berndt Urlesberger; Bernhard Schwaberger; Georg M. Schmölzer; Gerhard Pichler. Cerebral Doppler Resistance Index (RI) is associated with regional cerebral oxygenation. Acta Paediatrica 2020, 109, 2299 -2301.
AMA StyleNariae Baik‐Schneditz, Nina Höller, Berndt Urlesberger, Bernhard Schwaberger, Georg M. Schmölzer, Gerhard Pichler. Cerebral Doppler Resistance Index (RI) is associated with regional cerebral oxygenation. Acta Paediatrica. 2020; 109 (11):2299-2301.
Chicago/Turabian StyleNariae Baik‐Schneditz; Nina Höller; Berndt Urlesberger; Bernhard Schwaberger; Georg M. Schmölzer; Gerhard Pichler. 2020. "Cerebral Doppler Resistance Index (RI) is associated with regional cerebral oxygenation." Acta Paediatrica 109, no. 11: 2299-2301.
Background: According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO2). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO2) may further offer quantitative information on neonatal respiratory status. Objective: We aimed to investigate feasibility of tcpCO2 measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO2 between stable term and preterm infants. Methods: Neonates without need for cardio-respiratory intervention during immediate transition after birth were enrolled in a prospective observational study. In these term and preterm neonates, we measured HR and SpO2 by pulse oximetry on the right wrist and tcpCO2 with the sensor applied on the left hemithorax during the first 15 min after birth. Courses of tcpCO2 were analyzed in term and preterm neonates and groups were compared. Results: Fifty-three term (gestational age: 38.8 ± 0.9 weeks) and 13 preterm neonates (gestational age: 34.1 ± 1.5 weeks) were included. First tcpCO2 values were achieved in both groups at minute 4 after birth, which reached a stable plateau after the equilibration phase at minute 9. Mean tcpCO2 values 15 min after birth were 46.2 (95% CI 34.5–57.8) mmHg in term neonates and 48.5 (95%CI 43.0–54.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO2 values at any time point. Conclusion: This study demonstrates that tcpCO2 measurement is feasible during immediate neonatal transition after birth and that tcpCO2 values were comparable in stable term and preterm neonates.
Ilia Bresesti; Marlies Bruckner; Christian Mattersberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study. Frontiers in Pediatrics 2020, 8, 1 .
AMA StyleIlia Bresesti, Marlies Bruckner, Christian Mattersberger, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Alexander Avian, Berndt Urlesberger, Gerhard Pichler. Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study. Frontiers in Pediatrics. 2020; 8 ():1.
Chicago/Turabian StyleIlia Bresesti; Marlies Bruckner; Christian Mattersberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. 2020. "Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth—A Prospective Observational Study." Frontiers in Pediatrics 8, no. : 1.
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 Analysis of secondary outcome parameters of a prospective observational study which was performed 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 was 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.
Marlies Bruckner; Corinna Binder‐Heschl; Bernhard Schwaberger; Lukas Peter Mileder; Nariae Baik‐Schneditz; Martin Koestenberger; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. Cerebral and peripheral tissue oxygenation in stable neonates: Absent influence of cardiac function. Acta Paediatrica 2020, 109, 1560 -1569.
AMA StyleMarlies Bruckner, Corinna Binder‐Heschl, Bernhard Schwaberger, Lukas Peter Mileder, Nariae Baik‐Schneditz, Martin Koestenberger, Alexander Avian, Berndt Urlesberger, Gerhard Pichler. Cerebral and peripheral tissue oxygenation in stable neonates: Absent influence of cardiac function. Acta Paediatrica. 2020; 109 (8):1560-1569.
Chicago/Turabian StyleMarlies Bruckner; Corinna Binder‐Heschl; Bernhard Schwaberger; Lukas Peter Mileder; Nariae Baik‐Schneditz; Martin Koestenberger; Alexander Avian; Berndt Urlesberger; Gerhard Pichler. 2020. "Cerebral and peripheral tissue oxygenation in stable neonates: Absent influence of cardiac function." Acta Paediatrica 109, no. 8: 1560-1569.
Objective: To investigate if preterm neonates with arterial oxygen saturation (SpO2)<80% at 5 min after birth show different regional cerebral tissue oxygen saturation (rcStO2), compared to infants reaching the target. Methods: Retrospective analysis of four prospective observational studies. Preterm neonates needing respiratory support during delivery room stabilization were included. Regional cerebral tissue oxygen saturation was measured with near-infrared spectroscopy (NIRS) during the first 15 min after birth along with SpO2 and heart rate (HR). Neonates were divided into two groups: those with a 5-min SpO2 ≥ 80% (“≥80% group”) and those with a 5-min SpO2 < 80% (“<80% group”). Groups were compared regarding rcStO2, SpO2, and HR. Furthermore, we analyzed whether a 5-min SpO2 < 80% was associated with a rcStO2 below the 10th percentile at the same time point. Results: 146 neonates were included, with 68 (47%) in the “≥80% group” and 78 (53%) in the “<80% group.” Neonates in the “<80% group” had a significantly lower rcStO2 (p < 0.001). Furthermore, 80.3% of neonates in the “<80% group” and 23.4% in the “≥80% group” had rcStO2 values below the 10th percentile at 5 min (p < 0.001). HR was significantly lower at minute 3 and 4 in the “<80% group” (p < 0.002). Conclusion: Preterm infants needing respiratory support, who do not reach the SpO2 target of 80% at 5 min after birth, show significantly diminished rcStO2 values compared to neonates reaching the target.
Corinna Binder-Heschl; Gerhard Pichler; Alexander Avian; Bernhard Schwaberger; Nariae Baik-Schneditz; Lukas Mileder; Stefan Heschl; Berndt Urlesberger. Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation? Frontiers in Pediatrics 2019, 7, 1 .
AMA StyleCorinna Binder-Heschl, Gerhard Pichler, Alexander Avian, Bernhard Schwaberger, Nariae Baik-Schneditz, Lukas Mileder, Stefan Heschl, Berndt Urlesberger. Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation? Frontiers in Pediatrics. 2019; 7 ():1.
Chicago/Turabian StyleCorinna Binder-Heschl; Gerhard Pichler; Alexander Avian; Bernhard Schwaberger; Nariae Baik-Schneditz; Lukas Mileder; Stefan Heschl; Berndt Urlesberger. 2019. "Oxygen Saturation Targeting During Delivery Room Stabilization: What Does This Mean for Regional Cerebral Oxygenation?" Frontiers in Pediatrics 7, no. : 1.
Zusammenfassung Die präklinische Frühgeburt stellt ein seltenes, aber herausforderndes Einsatzszenario dar. Spezielle Handlungsempfehlungen für die Erstversorgung von Frühgeborenen unter den präklinischen Bedingungen für das eintreffende Rettungsdienstpersonal und für Notärzte existierten bislang nicht. Es werden regionale Handlungsempfehlungen für die Versorgung Frühgeborener in der Präklinik vorgestellt, die nach einer Häufung derartiger Einsätze in der Steiermark ausgearbeitet wurden.
Bernhard Schwaberger; Michael Eichinger; Johann Martensen; Nariae Baik-Schneditz; Mirjam Pocivalnik; Berndt Urlesberger. Regionale Handlungsempfehlungen zur notärztlichen Versorgung Frühgeborener nach präklinischer Geburt für die Steiermark. Der Notarzt 2019, 35, 314 -322.
AMA StyleBernhard Schwaberger, Michael Eichinger, Johann Martensen, Nariae Baik-Schneditz, Mirjam Pocivalnik, Berndt Urlesberger. Regionale Handlungsempfehlungen zur notärztlichen Versorgung Frühgeborener nach präklinischer Geburt für die Steiermark. Der Notarzt. 2019; 35 (06):314-322.
Chicago/Turabian StyleBernhard Schwaberger; Michael Eichinger; Johann Martensen; Nariae Baik-Schneditz; Mirjam Pocivalnik; Berndt Urlesberger. 2019. "Regionale Handlungsempfehlungen zur notärztlichen Versorgung Frühgeborener nach präklinischer Geburt für die Steiermark." Der Notarzt 35, no. 06: 314-322.
Background: Cerebral regional oxygen saturation (crSO2) during immediate transition and resuscitation immediately after birth is of increasing interest. Objectives: The aim of the present study was to assess whether the type of maternal anesthesia during cesarean section (CS; general anesthesia vs. spinal anesthesia) has an influence on cerebral oxygenation during immediate neonatal transition after birth. Methods: Secondary outcome parameters of prospective observational studies were analyzed. Neonates born by CS from November 2009 to September 2016 at the Medical University of Graz (Austria) were eligible. Term and preterm neonates were included, provided that: (1) crSO2 was measured by near-infrared spectroscopy, and (2) peripheral arterial oxygen saturation (SpO2) and heart rate (HR) were measured by pulse oximetry during the first 15 min after birth. Administration of supplemental oxygen was recorded and cerebral fractional tissue oxygen extraction (cFTOE) was calculated out of crSO2 and SpO2. For comparison, term and preterm neonates with maternal general anesthesia were matched to neonates with maternal spinal anesthesia during CS. Results: Out of 760 eligible neonates, 64 term (38.8 ± 0.9 weeks of gestation; 32 neonates in each group) and 54 preterm neonates (32.0 ± 2.9 weeks of gestation; 27 neonates in each group) were included. In term neonates, maternal general anesthesia was associated with lower initial SpO2, HR values, and Apgar scores. The fraction of inspired oxygen (FiO2) was statistically significantly higher in the general anesthesia group. Nevertheless, crSO2 and cFTOE did not differ statistically significantly between the groups. In preterm neonates there were no statistically significant differences in SpO2, HR, crSO2, and cFTOE between the general and spinal anesthesia groups. Apgar scores at 1 min were statistically significantly lower and FiO2 was statistically significantly higher in the general anesthesia group. Conclusion: Cerebral tissue oxygenation in neonates during immediate transition after birth was similar after maternal general and spinal anesthesia during CS, despite differences in SpO2, HR, and supplemental oxygen in term neonates and differences in supplemental oxygen in preterm neonates.
Isabella Willfurth; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Lukas Schober; Berndt Urlesberger; Gerhard Pichler. Cerebral Oxygenation in Neonates Immediately after Cesarean Section and Mode of Maternal Anesthesia. Neonatology 2019, 116, 132 -139.
AMA StyleIsabella Willfurth, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Lukas Schober, Berndt Urlesberger, Gerhard Pichler. Cerebral Oxygenation in Neonates Immediately after Cesarean Section and Mode of Maternal Anesthesia. Neonatology. 2019; 116 (2):132-139.
Chicago/Turabian StyleIsabella Willfurth; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Lukas Schober; Berndt Urlesberger; Gerhard Pichler. 2019. "Cerebral Oxygenation in Neonates Immediately after Cesarean Section and Mode of Maternal Anesthesia." Neonatology 116, no. 2: 132-139.
ZusammenfassungDie Kasuistik beschreibt die präklinische Reanimation eines extrem unreifen Frühgeborenen an der Grenze der Lebensfähigkeit. Es werden Aspekte des Wärmemanagements, der Atemwegssicherung und Notfallbeatmung, der Ausstattung von Notarztwagen und des Gestationsalter-abhängigen Vorgehens diskutiert.
Bernhard Schwaberger; Michael Schörghuber; Lukas Schober; Michael Eichinger; Berndt Urlesberger. Präklinische Reanimation eines extrem kleinen Frühgeborenen an der Grenze der Lebensfähigkeit – Kasuistik. Der Notarzt 2019, 35, 137 -140.
AMA StyleBernhard Schwaberger, Michael Schörghuber, Lukas Schober, Michael Eichinger, Berndt Urlesberger. Präklinische Reanimation eines extrem kleinen Frühgeborenen an der Grenze der Lebensfähigkeit – Kasuistik. Der Notarzt. 2019; 35 (3):137-140.
Chicago/Turabian StyleBernhard Schwaberger; Michael Schörghuber; Lukas Schober; Michael Eichinger; Berndt Urlesberger. 2019. "Präklinische Reanimation eines extrem kleinen Frühgeborenen an der Grenze der Lebensfähigkeit – Kasuistik." Der Notarzt 35, no. 3: 137-140.
Phonocardiogram analysis using the novel algorithm prototype had a higher sensitivity than auscultation by paediatrician in detecting positive echocardiography findings in neonates.
Renata Grgic-Mustafic; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Corinna Binder-Heschl; Jasmin Pansy; Martin Koestenberger; Berndt Urlesberger; Alexander Avian; Gerhard Pichler. Novel algorithm to screen for heart murmurs using computer-aided auscultation in neonates: a prospective single center pilot observational study. Minerva Pediatrica 2019, 71, 221 -228.
AMA StyleRenata Grgic-Mustafic, Nariae Baik-Schneditz, Bernhard Schwaberger, Lukas Mileder, Corinna Binder-Heschl, Jasmin Pansy, Martin Koestenberger, Berndt Urlesberger, Alexander Avian, Gerhard Pichler. Novel algorithm to screen for heart murmurs using computer-aided auscultation in neonates: a prospective single center pilot observational study. Minerva Pediatrica. 2019; 71 (3):221-228.
Chicago/Turabian StyleRenata Grgic-Mustafic; Nariae Baik-Schneditz; Bernhard Schwaberger; Lukas Mileder; Corinna Binder-Heschl; Jasmin Pansy; Martin Koestenberger; Berndt Urlesberger; Alexander Avian; Gerhard Pichler. 2019. "Novel algorithm to screen for heart murmurs using computer-aided auscultation in neonates: a prospective single center pilot observational study." Minerva Pediatrica 71, no. 3: 221-228.
Background: Intrauterine growth restriction (IUGR) is associated with adverse perinatal outcome. Affected foetuses display typical blood flow redistribution towards the brain (‘brain-sparing’). Accordingly, increased cerebral oxygen saturation has been observed in IUGR neonates within the first days of life. Aim: Aim of our study was to assess behaviour of cerebral oxygenation
Nariae Baik; Gerhard Pichler; Bernhard Schwaberger; Lukas Mileder. 01 - EFFECT OF INTRAUTERINE GROWTH RESTRICTION ON CEREBRAL OXYGENATION IN PRETERM AND TERM NEONATES DURING NEONATAL TRANSITION. 2018, 1 .
AMA StyleNariae Baik, Gerhard Pichler, Bernhard Schwaberger, Lukas Mileder. 01 - EFFECT OF INTRAUTERINE GROWTH RESTRICTION ON CEREBRAL OXYGENATION IN PRETERM AND TERM NEONATES DURING NEONATAL TRANSITION. . 2018; ():1.
Chicago/Turabian StyleNariae Baik; Gerhard Pichler; Bernhard Schwaberger; Lukas Mileder. 2018. "01 - EFFECT OF INTRAUTERINE GROWTH RESTRICTION ON CEREBRAL OXYGENATION IN PRETERM AND TERM NEONATES DURING NEONATAL TRANSITION." , no. : 1.
We sought to compare the effectiveness of two versus five fingers used for bag-valve-mask (BVM) ventilation on effective tidal volume (VTeff) delivery in an infant resuscitation model. In a randomised cross-over study, 40 healthcare professionals ventilated a modified leak-free infant resuscitation manikin with both two and five fingers, using a self-inflating bag. The delivered and effective tidal volumes, ventilation rate, and mask leak were measured and recorded using a respiratory function monitor. We found no significant differences in the VTeff (five-finger 61.7 ± 23.9 vs. two-finger 58.8 ± 16.6 mL; p = 0.35) or ventilatory minute volume (2.71 ± 1.59 vs. 2.76 ± 1.24 L/min; p = 0.40) of both BVM ventilation techniques. However, there was an increase in the delivered tidal volume (VTdel) and mask leak when using the five-finger technique compared with the two-finger technique (VTdel 96.1 ± 19.4 vs. 87.7 ± 15.5 mL; p < 0.01; and mask leak 34.6 ± 23.0 vs. 30.0 ± 21.0%; p = 0.02). Although the five-finger technique was associated with an increased mask leak, the number of fingers used during the BVM ventilation had no effect on VTeff in an infant resuscitation model.
David Zweiker; Hanna Schwaberger; Berndt Urlesberger; Lukas P Mileder; Nariae Baik-Schneditz; Gerhard Pichler; Georg M Schmölzer; Bernhard Schwaberger. Does the Number of Fingers on the Bag Influence Volume Delivery? A Randomized Model Study of Bag-Valve-Mask Ventilation in Infants. Children 2018, 5, 132 .
AMA StyleDavid Zweiker, Hanna Schwaberger, Berndt Urlesberger, Lukas P Mileder, Nariae Baik-Schneditz, Gerhard Pichler, Georg M Schmölzer, Bernhard Schwaberger. Does the Number of Fingers on the Bag Influence Volume Delivery? A Randomized Model Study of Bag-Valve-Mask Ventilation in Infants. Children. 2018; 5 (10):132.
Chicago/Turabian StyleDavid Zweiker; Hanna Schwaberger; Berndt Urlesberger; Lukas P Mileder; Nariae Baik-Schneditz; Gerhard Pichler; Georg M Schmölzer; Bernhard Schwaberger. 2018. "Does the Number of Fingers on the Bag Influence Volume Delivery? A Randomized Model Study of Bag-Valve-Mask Ventilation in Infants." Children 5, no. 10: 132.
To assess a possible association of blood glucose concentration with cerebral regional oxygen saturation (crSO2) and cerebral fractional tissue oxygen extraction (cFTOE) in neonates born at term and preterm 15 minutes after birth. A post-hoc analysis of secondary outcome measures of 2 prospective observational studies was performed. Neonates born at term and preterm via cesarean delivery were included if cerebral near-infrared spectroscopy measurements were performed during the immediate transition after birth and blood glucose concentrations were measured at 15-20 minutes after birth. Arterial oxygen saturation and heart rate were measured with pulse oximetry. cFTOE was calculated from arterial oxygen saturation and crSO2 values. crSO2 and cFTOE 15 minutes after birth were correlated with blood glucose concentrations. Seventy-five infants were included. In 50 neonates born at term, crSO2 and cFTOE 15 minutes after birth were 83 ± 7.7% and 0.14 ± 0.08, respectively. In 25 neonates born preterm, crSO2 and cFTOE 15 minutes after birth were 80.2 ± 12.1%, and 0.15 ± 0.1, respectively. crSO2 and cFTOE correlated significantly with blood glucose concentrations in neonates born at term and preterm. Increasing blood glucose concentrations were associated with decreasing crSO2 in neonates born at term (q = –0.35, P = .01) and neonates born preterm (q = –0.69, P = .01) and with increasing cFTOE in neonates born at term (q = 0.31, P = .03) and neonates born preterm (q = 0.67, P = .01). Blood glucose concentration was associated with cerebral oxygenation during the immediate transition after birth in neonates born at term and preterm.
Christian Matterberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Georg M. Schmölzer; Lukas Mileder; Elisabeth Pichler-Stachl; Berndt Urlesberger; Gerhard Pichler. Blood Glucose and Cerebral Tissue Oxygenation Immediately after Birth—An Observational Study. The Journal of Pediatrics 2018, 200, 19 -23.
AMA StyleChristian Matterberger, Nariae Baik-Schneditz, Bernhard Schwaberger, Georg M. Schmölzer, Lukas Mileder, Elisabeth Pichler-Stachl, Berndt Urlesberger, Gerhard Pichler. Blood Glucose and Cerebral Tissue Oxygenation Immediately after Birth—An Observational Study. The Journal of Pediatrics. 2018; 200 ():19-23.
Chicago/Turabian StyleChristian Matterberger; Nariae Baik-Schneditz; Bernhard Schwaberger; Georg M. Schmölzer; Lukas Mileder; Elisabeth Pichler-Stachl; Berndt Urlesberger; Gerhard Pichler. 2018. "Blood Glucose and Cerebral Tissue Oxygenation Immediately after Birth—An Observational Study." The Journal of Pediatrics 200, no. : 19-23.