A Left-to-Right Shunt via the Ductus Arteriosus Is Associated with Increased Regional Cerebral Oxygen Saturation during Neonatal Transition

Background: Oxygen delivery tOthe brain is dependent on cardiac output and arterial oxygen content. Objectives: The study was designed to investigate the influence of a left-toright shunt via the ductus arteriosus (DA) on regional oxygen saturation (rSO(2)) of the brain and peripheral tissue during postnatal transition. Methods: Nested case-control study. In term neonates after elective cesarian section, rSO(2) of the brain and pre-and postductal peripheral tissue were measured 15 min after uncomplicated postnatal transition. TwOgroups were formed according to shunt flow characteristics via the DA: shunt group (with a left-to-right shunt), and nonshunt group (no shunt). Results: Of 80 infants, in 58 (72%) a left-to-right shunt was identified, and in 22 (28%) no flow was seen via the DA. The 22 infants formed the nonshunt group. They were matched with 22 newborn infants with a left-to-right shunt via the DA (shunt group). Infants in the nonshunt group had significantly lower cerebral rSO(2) values and higher fractional tissue oxygen extraction and heart rate values. There were no significant differences in regard to peripheral rSO(2) values. Conclusion: During post-natal transition, term infants with a left-to-right shunt via the DA have significantly higher cerebral rSO(2) values compared to infants without shunt flow. Copyright (C) 2013 S. Karger AG, Basel