The aim of this study is to investigate the relationship between cerebral and peripheral oxygenation and oxygen extraction, as measured by NIRS (near-infrared spectroscopy ), and the FHbF (fraction of fetal hemoglobin) and absolute HbF (fetal hemoglobin) concentration in postnatal conditions in term and preterm neonates.
During gestation the main fetal oxygen carrier is fetal hemoglobin (HbF). HbF exhibits a significantly higher affinity for oxygen when compared to adult hemoglobin (HbA), which makes it more suitable for oxygen extraction at the lower partial oxygen pressures in utero. Although the regulation of HbF expression is determined developmentally, recent studies report a respectable variation in the fraction of HbF in neonates. Such data suggest that the differences in HbF expression could affect end-tissue oxygenation in neonates. The methodology for measuring oxygen saturation and extraction in cerebral and peripheral tissues of neonates using the near-infrared spectroscopy (NIRS) has been well practiced in our study group. However, the method has not yet been used to investigate whether the fraction of fetal hemoglobin (FHbF) plays a significant role in cerebral and peripheral oxygenation in neonates. The aim of this study is to investigate the relationship between cerebral and peripheral oxygenation and oxygen extraction, as measured by NIRS, and the FHbF and absolute HbF concentration in postnatal conditions in term and preterm neonates.
Study Type
OBSERVATIONAL
Enrollment
50
For NIRS measurements the t-NIRS 1 and NIRO 200 NX (Hamamatsu, Japan) will be used. A cerebral sensor will be placed and fixed with a CPAP (Continuous Positive Airway Pressure) cap on the left forehead and a peripheral sensor on the right forearm. Duration of measurement will be two hours.
Department of Pediatrics, Division of Neonatology, Medical University of Graz
Graz, Styria, Austria
FHbF (%)
Fraction of fetal hemoglobin in percentage
Time frame: First two weeks after birth
HbF (g/dL)
Fetal hemoglobin concentration in g/dL
Time frame: First two weeks after birth
Change of cTOI
cerebral tissue oxygenation index (cTOI)
Time frame: at specific time points (2nd-3rd 6th-8th, 12th-14th day after birth)
Change of pTOI
peripheral tissue oxygenation index (pTOI)
Time frame: at specific time points (2nd-3rd 6th-8th, 12th-14th day after birth)
Change of cFTOE
cerebral fractional tissue oxygen extraction (cFTOE)
Time frame: at specific time points (2nd-3rd 6th-8th, 12th-14th day after birth)
Change of pFTOE
peripheral fractional tissue oxygen extraction (pFTOE)
Time frame: at specific time points (2nd-3rd 6th-8th, 12th-14th day after birth)
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