Feasibilty of Transcutaneous pCO2 Monitoring During Immediate Transition After Birth\u2014A Prospective Observational Study

Background: According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO2). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO2) may further offer quantitative information on neonatal respiratory status. Objective: We aimed to investigate feasibility of tcpCO2 measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO2 between stable term and preterm infants. Methods: Neonates without need for cardio-respiratory intervention during immediate transition after birth were enrolled in a prospective observational study. In these term and preterm neonates, we measured HR and SpO2 by pulse oximetry on the right wrist and tcpCO2 with the sensor applied on the left hemithorax during the first 15 min after birth. Courses of tcpCO2 were analyzed in term and preterm neonates and groups were compared. Results: Fifty-three term (gestational age: 38.8 \ub1 0.9 weeks) and 13 preterm neonates (gestational age: 34.1 \ub1 1.5 weeks) were included. First tcpCO2 values were achieved in both groups at minute 4 after birth, which reached a stable plateau after the equilibration phase at minute 9. Mean tcpCO2 values 15 min after birth were 46.2 (95% CI 34.5\u201357.8) mmHg in term neonates and 48.5 (95%CI 43.0\u201354.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO2 values at any time point. Conclusion: This study demonstrates that tcpCO2 measurement is feasible during immediate neonatal transition after birth and that tcpCO2 values were comparable in stable term and preterm neonates

Impact of bradycardia and hypoxemia on oxygenation in preterm infants requiring respiratory support at birth

Aim of the study: Analysis of the impact of bradycardia and hypoxemia on the course of cerebral and peripheral oxygenation parameters in preterm infants in need for respiratory support during foetal-to-neonatal transition. Methods: The first 15 min after birth of 150 preterm neonates in need for respiratory support born at the Division of Neonatology, Graz (Austria) were analyzed. Infants were divided into different groups according to duration of bradycardia exposure (no Bradycardia, brief bradycardia <2 min, and prolonged bradycardia 652 min) and to systemic oxygen saturation (SpO2) value at 5 min of life (<80% or 6580%). Analysis was performed considering the degree of bradycardia alone (step 1) and in association with the presence of hypoxemia (step 2). Results: In step 1, courses of SpO2 differed significantly between bradycardia groups (p = 0.002), while courses of cerebral regional oxygen saturation (crStO2) and cerebral fractional tissue oxygen extraction (cFTOE) were not influenced (p = 0.382 and p = 0.878). In step 2, the additional presence of hypoxemia had a significant impact on the courses of SpO2 (p < 0.001), crStO2 (p < 0.001) and cFTOE (p = 0.045). Conclusion: Our study shows that the degree of bradycardia has a significant impact on the course of SpO2 only, but when associated with the additional presence of hypoxemia a significant impact on cerebral oxygenation parameters was seen (crStO2, cFTOE). Furthermore, the additional presence of hypoxemia has a significant impact on FiO2 delivered. Our study emphasizes the importance of HR and SpO2 during neonatal resuscitation, underlining the relevance of hypoxemia during the early transitional phase

Fit to Race: Identifying the balance, type and sources of knowledge in fitness for Motorsport

In Motorsport, due perhaps to a lack of empirical evidence, it is not always clear what fitness training is required and what roles specific fitness components play, particularly outside the elite levels. Consequently, drivers and their trainers are often left to their own devices, placing reliance on anecdotal information. Accordingly, using a large sample of racing drivers, coaches and fitness trainers, the aim of this investigation was to identify the perceived importance and contribution of fitness components, the sources of information used to reach these conclusions and levels of confidence in the views reported. Survey data from 166 drivers (151 males, 15 females) showed that, in general, cardiovascular fitness, upper body strength, coordination and reactions were perceived as being the most important. Data on sources of information used supported the conjecture that training can often be based on “word of mouth”. Despite a fairly high level of confidence in the views expressed, there is clearly a significant opportunity for practitioners working within Motorsport to provide clearer, proven information so that drivers can feel confident that they are training optimally