Cerebral Tissue Oxygen Saturation Measurements in Perinatal Asphyxia Cases Treated with Therapeutic Hypothermia.

Abstract

Cerebral tissue oxygen saturation (CrSO₂) measured with near-infrared spectroscopy (NIRS) technology has recently become the subject of several research studies. The aim of this study was to investigate the diagnostic value of CrSO₂ measurements in perinatal asphyxia (PA) cases. The study included a patient group of 42 PA cases, who were to be applied with therapeutic hypothermia (TH), and a control group of 42 healthy term newborns. PA cases were determined as moderate or severe encephalopathy (Sarnat score stage II or III) in clinical evaluation. In both groups, left (CrSO₂L) and right (CrSO₂R) NIRS measurements were taken for 10 minutes on the scalp. The arithmetic mean value of measurements was calculated and compared. The mean measurements were CrSO₂R 67.38 ± 9.39 and CrSO₂L 66.73 ± 7.76 in the patient group, and CrSO₂R 80.28 ± 8.04 and CrSO₂L 79.14 ± 8.49 in the control group. The mean CrSO₂R and CrSO₂L measurements of the patient group were statistically significantly lower than those of the control group (p < 0.001). In the Pearson correlation analysis, a significant correlation was determined in the patient group between cord blood gas pH and CrSO₂R (r: 0.539, p < 0.001) and CrSO₂L (r: 0.54, p < 0.001). For a cutoff value of CrSO₂L ≤ 72%, the positive predictive value was 80 and the negative predictive value was 84.6. For a cutoff value of CrSO₂R ≤ 74%, the positive predictive value was 79.5 and the negative predictive value was 82.5. Low CrSO₂ measurements obtained with the NIRS method in PA cases to be applied with TH together with cord blood gas parameters can be considered a helpful parameter in diagnosis.