Scholarlink

<p>Umbilical cord clamping management may affect cerebral oxygenation (rSO<sub>2</sub>C), but previous studies have only investigated effects in the first minutes of life. Our objective was to determine whether delayed cord clamping (DCC) and umbilical cord milking (UCM) differently affect cerebral oxygenation and cardiovascular function in the first 24&#xa0;h of life in preterm infants. A post-hoc secondary outcome analysis of a multicentre prospective randomised clinical trial (PCI), conducted between April 2016 and February 2023 at 8 Italian neonatal intensive care units. The present ancillary study included preterm infants with 23<sup>+0</sup>–29<sup>+6</sup> 30&#xa0;weeks’ gestation. One hundred and five infants received DCC and 104 UCM during resuscitation. Cerebral regional tissue oxygenation (rSO<sub>2</sub>C) was measured by near-infrared spectroscopy (NIRS) at 3 (T<sub>3h</sub>), 6 (T<sub>6h</sub>), 12 (T<sub>12h</sub>), 18 (T<sub>18h</sub>), and 24 (T<sub>24h</sub>) hours of life. Cardiovascular function was assessed by echocardiography within the first 24&#xa0;h of life. We found that rSO<sub>2</sub>C was higher at T<sub>3h</sub> [79 (76–84) vs. 78% (74–82), <i>P</i> = 0.04)] and T<sub>12h</sub> [79 (76–83) vs. 78% (74–80), <i>P</i> = 0.01] in the DCC than in the UCM group. Left ventricular output (LVO) was lower [196 (182–301) vs. 232 (182–301) ml/Kg/min, <i>P</i> = 0.02] in the DCC than in the UCM group, while right ventricular output (RVO) and superior vena cava (SVC) flow were similar. The need for dopamine was higher (26 vs. 23%, <i>P</i> = 0.02) in the in the DCC than in the UCM group.</p><p><i>Conclusion</i>: rSO<sub>2</sub>C was transiently higher in preterm infants resuscitated with DCC in comparison with UCM, but this difference was not clinically relevant. The lower LVO value in the DCC group compared to the UCM group deserves further studies to be confirmed and interpreted.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Effect of delayed cord clamping and cord milking on cerebral oxygenation and cardiovascular function: a secondary analysis of the PCI trial

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年2月16日

查看全文
  • Simone Pratesi,
  • Stefano Ghirardello,
  • Cristiana Germini,
  • Miria Natile,
  • Stefania Vedovato,
  • Giovanna Mescoli,
  • Roberta Corbetta,
  • Flavia Petrillo,
  • Anna Lavizzari,
  • Silvia Perugi,
  • Luca Boni,
  • Carlo Dani

摘要

Umbilical cord clamping management may affect cerebral oxygenation (rSO2C), but previous studies have only investigated effects in the first minutes of life. Our objective was to determine whether delayed cord clamping (DCC) and umbilical cord milking (UCM) differently affect cerebral oxygenation and cardiovascular function in the first 24 h of life in preterm infants. A post-hoc secondary outcome analysis of a multicentre prospective randomised clinical trial (PCI), conducted between April 2016 and February 2023 at 8 Italian neonatal intensive care units. The present ancillary study included preterm infants with 23+0–29+6 30 weeks’ gestation. One hundred and five infants received DCC and 104 UCM during resuscitation. Cerebral regional tissue oxygenation (rSO2C) was measured by near-infrared spectroscopy (NIRS) at 3 (T3h), 6 (T6h), 12 (T12h), 18 (T18h), and 24 (T24h) hours of life. Cardiovascular function was assessed by echocardiography within the first 24 h of life. We found that rSO2C was higher at T3h [79 (76–84) vs. 78% (74–82), P = 0.04)] and T12h [79 (76–83) vs. 78% (74–80), P = 0.01] in the DCC than in the UCM group. Left ventricular output (LVO) was lower [196 (182–301) vs. 232 (182–301) ml/Kg/min, P = 0.02] in the DCC than in the UCM group, while right ventricular output (RVO) and superior vena cava (SVC) flow were similar. The need for dopamine was higher (26 vs. 23%, P = 0.02) in the in the DCC than in the UCM group.

Conclusion: rSO2C was transiently higher in preterm infants resuscitated with DCC in comparison with UCM, but this difference was not clinically relevant. The lower LVO value in the DCC group compared to the UCM group deserves further studies to be confirmed and interpreted.