Moerman, K.C.W. (Kimberly) (2014) The effect of extra oxygen administration during an apnea on cerebral saturation in preterm neonates. thesis, Medicine.
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Abstract
Background and Purpose: Preterm infants often experience apneas of prematurity followed by desaturations due to their underdeveloped brain and respiratory centre. Extra oxygen is administered by the nursing staff in most of the cases to help recover from the desaturations in the preterms. This may be the cause of an oxygen overshoot which is associated with brain damage. Near infrared spectroscopy (NIRS) will be used to determine what the course is of the regional cerebral saturation (rScO2) after a decrease in saturation in premature infants with desaturations. Also, the effects on cerebral saturation when extra O2 is administered during an apnea followed by a desaturation will be further investigated. Methods: This study include 16 preterm infants which experienced in total 50 apneas (median gestational age 28+4 weeks, ranging 25+0 – 30+0 weeks; birth weigh 1144 gram, ranging 800 – 1630 gram. rScO2, SpO2 and heart rate were measured with during day 2 to 5 for about 2 to 24 hours a day. cFTOE was calculated as cFTOE = [(SpO2 – rScO2 )/SpO2 ]. Results: We found significant higher cerebral saturation values after desaturation compared to before the desaturation had occurred with and without increased fraction inspired oxygen (FiO2). Also, there were no differences in recovery after the desaturation when increasing FiO2 temporarily or continuously during the desaturation. The cFTOE was lower after the desaturation compared to before both when the FiO2 was increased and when not increased during desaturation. Conclusion: With the usage of NIRS we came to the conclusion that an overshoot in cerebral saturation always follows after a desaturation whether extra oxygen is administrated or not after an AOP resulting in a desaturation. Apparently this is solely the consequence of post-hypoxic reperfusion which occurs after a desaturation. This is supported by the fact that cerebral fractional tissue oxygen extraction is lower during the recovery period when hyperperfysion occurs.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Kooi, E.M.W. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/334 |
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