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Cerebrovascular responses to a 90° tilt in healthy neonates.
Tran, Nhu N; Chwa, Jason S; Brady, Kenneth M; Borzage, Matthew; Brecht, Mary-Lynn; Woon, Jessica X; Miner, Anna; Merkel, Carlin A; Friedlich, Philippe; Peterson, Bradley S; Wood, John C.
Afiliación
  • Tran NN; Institute for the Developing Mind, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA. ntran@chla.usc.edu.
  • Chwa JS; Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Los Angeles, CA, USA. ntran@chla.usc.edu.
  • Brady KM; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. ntran@chla.usc.edu.
  • Borzage M; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Brecht ML; Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • Woon JX; Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Los Angeles, CA, USA.
  • Miner A; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Merkel CA; School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.
  • Friedlich P; Dornsife College of Letters, Arts and Sciences, University of Southern California, Los Angeles, CA, USA.
  • Peterson BS; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
  • Wood JC; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Pediatr Res ; 95(7): 1851-1859, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38280952
ABSTRACT

BACKGROUND:

Tilts can induce alterations in cerebral hemodynamics in healthy neonates, but prior studies have only examined systemic parameters or used small tilt angles (<90°). The healthy neonatal population, however, are commonly subjected to large tilt angles (≥90°). We sought to characterize the cerebrovascular response to a 90° tilt in healthy term neonates.

METHODS:

We performed a secondary descriptive analysis on 44 healthy term neonates. We measured cerebral oxygen saturation (rcSO2), oxygen saturation (SpO2), heart rate (HR), breathing rate (BR), and cerebral fractional tissue oxygen extraction (cFTOE) over three consecutive 90° tilts. These parameters were measured for 2-min while neonates were in a supine (0°) position and 2-min while tilted to a sitting (90°) position. We measured oscillometric mean blood pressure (MBP) at the start of each tilt.

RESULTS:

rcSO2 and BR decreased significantly in the sitting position, whereas cFTOE, SpO2, and MBP increased significantly in the sitting position. We detected a significant position-by-time interaction for all physiological parameters.

CONCLUSION:

A 90° tilt induces a decline in rcSO2 and an increase in cFTOE in healthy term neonates. Understanding the normal cerebrovascular response to a 90° tilt in healthy neonates will help clinicians to recognize abnormal responses in high-risk infant populations. IMPACT Healthy term neonates (≤14 days old) had decreased cerebral oxygen saturation (~1.1%) and increased cerebral oxygen extraction (~0.01) following a 90° tilt. We detected a significant position-by-time interaction with all physiological parameters measured, suggesting the effect of position varied across consecutive tilts. No prior study has characterized the cerebral oxygen saturation response to a 90° tilt in healthy term neonates.
Asunto(s)

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Circulación Cerebrovascular / Saturación de Oxígeno / Frecuencia Cardíaca Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Res Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Circulación Cerebrovascular / Saturación de Oxígeno / Frecuencia Cardíaca Límite: Female / Humans / Male / Newborn Idioma: En Revista: Pediatr Res Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos