80% OXYGEN ADMINISTERED TO NEWBORN PREMATURE INFANTS CAUSES PROLONGED CEREBRAL VASOCONSTRICTION

Abstract

Hypothesis Low values of cerebral blood flow(CBF) in newborn, premature infants may partly be due to excessive oxygen administration at birth.

Design In a prospective, randomized study of 70 preterm infants (GA<33 wks) we used 21%(GrI) or 80%(GrII) oxygen for the initial stabilisation in the delivery room. Infants in GrI received supplemental oxygen if clinically indicated. Two hours after birth, CBF was measured using the ¹³³Xe-clearance method and left ventricular output(LVO) was calculated using M-mode echocardiography and Doppler ultrasound velocimetry.

Results No difference in GA(median 28wks), BW(mean 1125gr), umb. cord pH, AS, use of antenatal steroid or mode of delivery was found between the groups. 9(26%) of the infants in GrI required supplemental oxygen (FiO₂<0.40) in the delivery room. These infants were included in the analysis(Gr I). Another infant required intubation before two hrs. of age and was excluded. At the time of measurements no significant differences in MABP, pCO₂, hemoglobine-conc., blood glucose or a/A-ratio were found.

ANCOVA revealed allocation to initial 80% oxygen as being the strongest and most significant factor (p<0.001).

Conclusion These results suggest cerebral vasoconstriction following a short period of oxygen administration at preterm birth, possibly related to a low antioxidant capacity of preterm infants.

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