Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial
ObjectivesTo evaluate cerebral tissue oxygenation index (cTOI) during neonatal transition in a group of healthy full-term neonates receiving either a physiological-based approach of deferred cord clamping (CC) after the onset of stable regular breathing (PBCC group) or a standard approach of time-ba...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.1005947/full |
| _version_ | 1797956765681188864 |
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| author | Bernhard Schwaberger Bernhard Schwaberger Bernhard Schwaberger Mirjam Ribitsch Gerhard Pichler Gerhard Pichler Gerhard Pichler Marlies Krainer Marlies Krainer Marlies Krainer Alexander Avian Alexander Avian Nariae Baik-Schneditz Nariae Baik-Schneditz Nariae Baik-Schneditz Evelyn Ziehenberger Evelyn Ziehenberger Evelyn Ziehenberger Lukas Peter Mileder Lukas Peter Mileder Lukas Peter Mileder Johann Martensen Johann Martensen Johann Martensen Christian Mattersberger Christian Mattersberger Christina Helene Wolfsberger Christina Helene Wolfsberger Christina Helene Wolfsberger Berndt Urlesberger Berndt Urlesberger Berndt Urlesberger |
| author_facet | Bernhard Schwaberger Bernhard Schwaberger Bernhard Schwaberger Mirjam Ribitsch Gerhard Pichler Gerhard Pichler Gerhard Pichler Marlies Krainer Marlies Krainer Marlies Krainer Alexander Avian Alexander Avian Nariae Baik-Schneditz Nariae Baik-Schneditz Nariae Baik-Schneditz Evelyn Ziehenberger Evelyn Ziehenberger Evelyn Ziehenberger Lukas Peter Mileder Lukas Peter Mileder Lukas Peter Mileder Johann Martensen Johann Martensen Johann Martensen Christian Mattersberger Christian Mattersberger Christina Helene Wolfsberger Christina Helene Wolfsberger Christina Helene Wolfsberger Berndt Urlesberger Berndt Urlesberger Berndt Urlesberger |
| author_sort | Bernhard Schwaberger |
| collection | DOAJ |
| description | ObjectivesTo evaluate cerebral tissue oxygenation index (cTOI) during neonatal transition in a group of healthy full-term neonates receiving either a physiological-based approach of deferred cord clamping (CC) after the onset of stable regular breathing (PBCC group) or a standard approach of time-based CC < 1 min (control group). Secondary aim was to evaluate changes in cerebral blood volume (ΔCBV), peripheral arterial oxygen saturation (SpO2) and heart rate (HR) in those neonates.Materials and MethodsWe conducted a randomized controlled trial (clinicaltrials.gov: NCT02763436) including vaginally delivered healthy full-term neonates. Continuous measurements of cTOI and ΔCBV using near-infrared spectroscopy, and of SpO2 and HR using pulse oximetry were performed within the first 15 min after birth. Data of each minute of the PBCC group were compared to those of the control group.ResultsA total of 71 full-term neonates (PBCC: n = 35, control: n = 36) with a mean (SD) gestational age of 40.0 (1.0) weeks and a birth weight of 3,479 (424) grams were included. Median (IQR) time of CC was 275 (197–345) seconds and 58 (35–86) seconds in the PBCC and control group, respectively (p < 0.001). There were no significant differences between the two groups regarding cTOI (p = 0.319), ΔCBV (p = 0.814), SpO2 (p = 0.322) and HR (p = 0.878) during the first 15 min after birth.ConclusionThere were no significant differences in the course of cTOI as well as ΔCBV, SpO2 and HR during the first 15 min after birth in a group of healthy full-term neonates, who received either deferred CC after the onset of stable regular breathing or standard CC < 1 min. Thus, deferring CC ≥ 1 min following a physiological-based approach offers no benefits regarding cerebral tissue oxygenation and perfusion after uncomplicated vaginal delivery compared to a time-based CC approach. |
| first_indexed | 2024-04-10T23:53:58Z |
| format | Article |
| id | doaj.art-e4540cd9093d49df822f68be5c20dc5c |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-10T23:53:58Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-e4540cd9093d49df822f68be5c20dc5c2023-01-10T14:49:28ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602023-01-011010.3389/fped.2022.10059471005947Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trialBernhard Schwaberger0Bernhard Schwaberger1Bernhard Schwaberger2Mirjam Ribitsch3Gerhard Pichler4Gerhard Pichler5Gerhard Pichler6Marlies Krainer7Marlies Krainer8Marlies Krainer9Alexander Avian10Alexander Avian11Nariae Baik-Schneditz12Nariae Baik-Schneditz13Nariae Baik-Schneditz14Evelyn Ziehenberger15Evelyn Ziehenberger16Evelyn Ziehenberger17Lukas Peter Mileder18Lukas Peter Mileder19Lukas Peter Mileder20Johann Martensen21Johann Martensen22Johann Martensen23Christian Mattersberger24Christian Mattersberger25Christina Helene Wolfsberger26Christina Helene Wolfsberger27Christina Helene Wolfsberger28Berndt Urlesberger29Berndt Urlesberger30Berndt Urlesberger31Research Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaPediatric Intensive Care Unit, Division of General Pediatrics, Department of Pediatrics and Adolescent Medicine, Medical University Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaInstitute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaResearch Unit for Cerebral Development and Oximetry, Medical University of Graz, Graz, AustriaResearch Unit for Neonatal Micro- and Macrocirculation, Medical University of Graz, Graz, AustriaDivision of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, AustriaObjectivesTo evaluate cerebral tissue oxygenation index (cTOI) during neonatal transition in a group of healthy full-term neonates receiving either a physiological-based approach of deferred cord clamping (CC) after the onset of stable regular breathing (PBCC group) or a standard approach of time-based CC < 1 min (control group). Secondary aim was to evaluate changes in cerebral blood volume (ΔCBV), peripheral arterial oxygen saturation (SpO2) and heart rate (HR) in those neonates.Materials and MethodsWe conducted a randomized controlled trial (clinicaltrials.gov: NCT02763436) including vaginally delivered healthy full-term neonates. Continuous measurements of cTOI and ΔCBV using near-infrared spectroscopy, and of SpO2 and HR using pulse oximetry were performed within the first 15 min after birth. Data of each minute of the PBCC group were compared to those of the control group.ResultsA total of 71 full-term neonates (PBCC: n = 35, control: n = 36) with a mean (SD) gestational age of 40.0 (1.0) weeks and a birth weight of 3,479 (424) grams were included. Median (IQR) time of CC was 275 (197–345) seconds and 58 (35–86) seconds in the PBCC and control group, respectively (p < 0.001). There were no significant differences between the two groups regarding cTOI (p = 0.319), ΔCBV (p = 0.814), SpO2 (p = 0.322) and HR (p = 0.878) during the first 15 min after birth.ConclusionThere were no significant differences in the course of cTOI as well as ΔCBV, SpO2 and HR during the first 15 min after birth in a group of healthy full-term neonates, who received either deferred CC after the onset of stable regular breathing or standard CC < 1 min. Thus, deferring CC ≥ 1 min following a physiological-based approach offers no benefits regarding cerebral tissue oxygenation and perfusion after uncomplicated vaginal delivery compared to a time-based CC approach.https://www.frontiersin.org/articles/10.3389/fped.2022.1005947/fulltiming of cord clampingneonatal transitioncerebral tissue oxygenation (index)cerebral blood volume (CBV)newborn infantnear-infrared spectroscopy |
| spellingShingle | Bernhard Schwaberger Bernhard Schwaberger Bernhard Schwaberger Mirjam Ribitsch Gerhard Pichler Gerhard Pichler Gerhard Pichler Marlies Krainer Marlies Krainer Marlies Krainer Alexander Avian Alexander Avian Nariae Baik-Schneditz Nariae Baik-Schneditz Nariae Baik-Schneditz Evelyn Ziehenberger Evelyn Ziehenberger Evelyn Ziehenberger Lukas Peter Mileder Lukas Peter Mileder Lukas Peter Mileder Johann Martensen Johann Martensen Johann Martensen Christian Mattersberger Christian Mattersberger Christina Helene Wolfsberger Christina Helene Wolfsberger Christina Helene Wolfsberger Berndt Urlesberger Berndt Urlesberger Berndt Urlesberger Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial Frontiers in Pediatrics timing of cord clamping neonatal transition cerebral tissue oxygenation (index) cerebral blood volume (CBV) newborn infant near-infrared spectroscopy |
| title | Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial |
| title_full | Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial |
| title_fullStr | Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial |
| title_full_unstemmed | Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial |
| title_short | Does physiological-based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates? – A randomized controlled trial |
| title_sort | does physiological based cord clamping improve cerebral tissue oxygenation and perfusion in healthy term neonates a randomized controlled trial |
| topic | timing of cord clamping neonatal transition cerebral tissue oxygenation (index) cerebral blood volume (CBV) newborn infant near-infrared spectroscopy |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.1005947/full |
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