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Updated: Aug 7, 2026
Non-invasive Optical Measurement of Cerebral Metabolism and Hemodynamics in Infants
Published on: March 14, 2013
Acid-base and metabolic parameters and cerebral oxygenation during the immediate transition after birth-A two-center
Christian Mattersberger1, Nariae Baik-Schneditz1,2, Bernhard Schwaberger1,2
1Department of Paediatrics and Adolescent Medicine, Division of Neonatology, Medical University of Graz, Graz, Styria, Austria.
Insights
Metabolic and acid-base status significantly impacts cerebral oxygenation in preterm neonates. In term neonates, only bicarbonate levels showed a correlation with cerebral fractional tissue oxygen extraction (FTOE).
Area of Science:
- Neonatal Medicine
- Perinatal Physiology
- Neurocritical Care
Background:
- Cerebral oxygenation, measured by cerebral regional oxygen saturation (crSO2) and cerebral fractional tissue oxygen extraction (FTOE), is crucial in neonates.
- Previous research has established a link between blood glucose and cerebral oxygenation.
Purpose of the Study:
- To investigate the influence of acid-base and metabolic parameters on immediate postnatal cerebral oxygenation in both preterm and term neonates.
Main Methods:
- Post-hoc analysis of two prospective observational studies involving neonates born via C-section.
- Cerebral near-infrared spectroscopy (NIRS) and capillary blood gas analysis were performed within the first 20 minutes after birth.
- Correlation analyses assessed associations between metabolic parameters (lactate, pH, base-excess, bicarbonate) and NIRS-derived crSO2 and FTOE.
Main Results:
- In preterm neonates, elevated lactate and lower pH/base-excess correlated with reduced crSO2 and increased FTOE.
- Term neonates showed a positive association between higher bicarbonate levels and increased FTOE.
- No significant associations were found between other metabolic parameters and cerebral oxygenation in term neonates.
Conclusions:
- Acid-base and metabolic derangements significantly affect cerebral oxygenation in preterm infants shortly after birth.
- In term neonates, the impact of these parameters on cerebral oxygenation is less pronounced, with only bicarbonate showing a correlation.
Objective:
The association between blood glucose level and cerebral oxygenation (cerebral regional oxygen saturation [crSO2] and cerebral fractional tissue oxygen extraction [FTOE]) in neonates has already been described. Aim of the present study was to investigate if acid-base and other metabolic parameters have an impact on cerebral oxygenation immediately after birth in preterm and term neonates.
Study Design:
Post-hoc analyses of secondary outcome parameters of two prospective observational studies were performed. Preterm and term neonates born by caesarean section were included, in whom i) cerebral near-infrared spectroscopy (NIRS) measurements were performed during the first 15 minutes after birth and ii) a capillary blood gas analysis was performed between 10 and 20 minutes after birth. Vital signs were routinely monitored with pulse oximetry (arterial oxygen saturation [SpO2] and heart rate [HR]). Correlation analyses were performed to investigate potential associations between acid-base and metabolic parameters (lactate [LAC], pH-value [pH], base-excess [BE] and bicarbonate [HCO3]) from capillary blood and NIRS-derived crSO2 and FTOE at 15 minutes after birth.
Results:
One-hundred-fifty-seven neonates, 42 preterm neonates (median gestational age [IQR] 34.0 weeks [3.3], median birth weight 1845g [592]) and 115 term neonates (median gestational age [IQR] 38.9 weeks [1.0], median birth weight 3230g [570]) were included in the study. Median crSO2 [IQR] values at 15 minutes after birth were 82% [16] in preterm neonates and 83% [12] in term neonates. Median FTOE [IQR] values at 15 minutes after birth were 0.13 [0.15] in preterm neonates and 0.14 [0.14] in term neonates. In preterm neonates, higher LAC and lower pH and BE were associated with lower crSO2 and higher FTOE. In term neonates, higher HCO3 was associated with higher FTOE.
Conclusion:
There were significant associations between several acid-base and metabolic parameters and cerebral oxygenation in preterm neonates, while in term neonates only HCO3 correlated positively with FTOE.
