Search

This document is a compilation of abstracts from the 15th International Newborn Brain Conference, focusing on various forms of brain monitoring in preterm neonates. The abstracts cover topics such as predicting posthemorrhagic ventricular dilatation in neonates with intraventricular hemorrhage, the association between blood lactate normalization and outcomes in neonates with hypoxic-ischemic encephalopathy, the implementation of cerebral near-infrared spectroscopy in a neonatal intensive care unit, cry analysis as a potential biomarker in newborn neurological assessment, and the impact of neonatal hypoxia on thyroid hormones. Another study investigates the use of near-infrared spectroscopy in assessing splanchnic oxygenation in preterm infants receiving minimal enteral nutrition. The document also includes the names and affiliations of the authors. [Extracted from the article]

Aim: The International Liaison Committee on Resuscitation Neonatal Life Support Task Force undertook a scoping review of the literature to identify evidence relating to neonatal cardiopulmonary resuscitation.Methods: MEDLINE complete, EMBASE and Cochrane database of Systematic reviews were searched from inception to November 2021. Two authors screened titles and abstracts and full text reviewed. Studies were eligible for inclusion if they were peer-reviewed and assessed one of five aspects of chest compression in the newborn infant including: (1) heart rate thresholds to start chest compressions (CC), (2) compression to ventilation ratio (C:V ratio), (3) CC technique, (4) oxygen use during CC and 5) feedback devices to optimise CC.Results: Seventy-four studies were included (n=46 simulation, n=24 animal and n=4 clinical studies); 22/74 were related to compression to ventilation ratios, 29/74 examined optimal technique to perform CC, 7/74 examined oxygen delivery and 15/74 described feedback devices during neonatal CC.Conclusion: There were very few clinical studies and mostly manikin and animal studies. The findings either reinforced or were insufficient to change previous recommendations which included to start CC if heart rate remains <60/min despite adequate ventilation, using a 3:1 C:V ratio, the two-thumb encircling technique and 100% oxygen during CC. [ABSTRACT FROM AUTHOR]

Background: The Neonatal Life Support Consensus on Science With Treatment Recommendations states that chest compressions (CC) be performed preferably with the 2-thumb encircling technique. The aim of this study was to compare the hemodynamic effects of four different finger positions during CC in a piglet model of neonatal asphyxia. Methods: Seven asphyxiated post-transitional piglets were randomized to CC with 2-thumb-, 2-finger-, knocking-fingers-, and over-the-head 2-thumb-techniques for one minute at each technique. CC superimposed with sustained inflations were performed manually. Results: Seven newborn piglets (age 0–4 days, weight 2.0–2.1 kg) were included in the study. The mean (SD) slope rise of carotid blood flow was significantly higher with the 2-thumb-technique and over-the-head 2-thumb-technique (118 (45) mL/min/s and 121 (46) mL/min/s, respectively) compared to the 2-finger-technique and knocking-finger-technique (75 (48) mL/min/s and 71 (67) mL/min/s, respectively) (p < 0.001). The mean (SD) dp/dtmin (as an expression of left ventricular function) was significantly lower with the 2-thumb-technique, with −1052 (369) mmHg/s, compared to −568 (229) mmHg/s and −578(180) mmHg/s (both p = 0.012) with the 2-finger-technique and knocking-finger-technique, respectively. Conclusion: The 2-thumb-technique and the over-the-head 2-thumb-technique resulted in improved slope rises of carotid blood flow and dp/dtmin during chest compression. [ABSTRACT FROM AUTHOR]

Background: To compare chest compression (CC) rates of 90/min with 180/min and their effect on the time to return of spontaneous circulation (ROSC), survival, hemodynamic, and respiratory parameters. We hypothesized that asphyxiated newborn piglets that received CC at 180/min vs. 90/min during cardiopulmonary resuscitation would have a shorter time to ROSC. Methods: Newborn piglets (n = 7/group) were anesthetized, intubated, instrumented and exposed to 45 min normocapnic hypoxia followed by asphyxia and cardiac arrest. Piglets were randomly allocated to a CC rate of 180/min or 90/min. CC was performed using an automated chest compression machine using CC superimposed with sustained inflation. Hemodynamic and respiratory parameters and applied compression force were continuously measured. Results: The mean (SD) time to ROSC was 91 (34) and 256 (97) s for CC rates of 180/min and 90/min, respectively (p = 0.08). The number of piglets that achieved ROSC was 7 (100%) and 5 (71%) with 180/min and 90/min CC rates, respectively (p = 0.46). Hemodynamic parameters (i.e., diastolic and mean blood pressure, carotid blood flow, stroke volume, end-diastolic volume, left ventricular contractile function) and respiratory parameters (i.e., minute ventilation, peak inflation and peak expiration flow) were all improved with a CC rate of 180/min. Conclusion: Time to ROSC and hemodynamic and respiratory parameters were not statistical significant different between CC rates of 90/min and 180/min. Higher CC rates during neonatal resuscitation warrant further investigation. [ABSTRACT FROM AUTHOR]

Introduction: Carbon dioxide (pCO2) induces changes in the tone of cerebral vessels. The aim of the present study was to evaluate the impact of pCO2 on cerebral regional tissue oxygen saturation (crSO2), cerebral fractional tissue oxygen extraction (cFTOE), and cerebral tissue oxygen extraction (cTOE), measured with near-infrared spectroscopy (NIRS), in preterm and term infants 15 min after birth. Methods: Post hoc analyses of secondary outcome parameters of prospective observational studies were performed. Stable preterm and term infants with cerebral NIRS monitoring (INVOS 5100C) until minute 15 after birth and a blood gas analysis, performed between minutes 14–18 after birth, were included. Heart rate (HR) and arterial oxygen saturation (SpO2) were recorded. pCO2 was correlated with crSO2, cFTOE, cTOE, SpO2, HR, and partial pressure of oxygen (pO2). Results: Eleven preterm infants with a median (IQR) gestational age of 34.8 (32.7–36.1) weeks were analyzed. Mean ± SD pCO2 was 53.5 ± 4.2 mm Hg. At minute 15 after birth, crSO2 was 82.6 (74.3–91.3)%, cFTOE 0.15 ± 0.09, cTOE 14.6 ± 8.4%, SpO2 97.4 ± 2.1%, and HR 152 (136–167) bpm. pCO2 correlated negatively with crSO2 (p = 0.012) and positively with cFTOE (p = 0.035) and cTOE (p = 0.037). Eighty-four term infants with a gestational age of 39.0 (38.5–38.9) weeks were analyzed. pCO2 was 53.5 ± 6.3 mm Hg. At minute 15 after birth, crSO2 was 84.4 (80.8–85.1)%, cFTOE 0.14 ± 0.08, cTOE 13.6 ± 7.9%, SpO2 96.5 ± 2.6%, and HR 155 (153–163) bpm. pCO2 did only negatively correlate with pO2 (p = 0.034) in term infants. Conclusion: In preterm infants, higher pCO2 was associated with lower crSO2 and higher cFTOE/cTOE. In term infants, no associations were observed. The present findings suggest that the vasodilatative effect of pCO2 is less pronounced in preterm infants during immediate postnatal transition. [ABSTRACT FROM AUTHOR]

Recent guidelines recommend the umbilical venous catheter (UVC) as the optimal vascular access method during neonatal resuscitation. In emergencies the UVC securement may be challenging and time-consuming. This experimental study was designed to test the feasibility of new concepts for the UVC securement. Umbilical cord remnants were catheterized with peripheral catheters and secured with disposable umbilical clamps. Three different securement techniques were investigated. Secure 1: the disposable umbilical clamp was closed at the level of the inserted catheter. Secure 2: the clamp was closed at the junction of the catheter and plastic wings. Secure 3: the setting of Secure 2 was combined with an umbilical tape. The main outcomes were the feasibility of fluid administration and the maximum force to release the securement. This study shows that inserting peripheral catheters into the umbilical vein and securing them with disposable umbilical clamps is feasible. Rates of lumen obstruction and the effectiveness of the securement were superior with Secure 2 and 3 compared to Secure 1. This new approach may be a rewarding option for umbilical venous catheterization and securement particularly in low-resource settings and for staff with limited experience in neonatal emergencies. However, although promising, these results need to be confirmed in clinical trials before being introduced into clinical practice. [ABSTRACT FROM AUTHOR]

Background: Current neonatal resuscitation guidelines recommend chest compressions (CCs) should be delivered to a depth of approximately 1/3 of the anterior-posterior (AP) chest diameter. The aim of the study was to investigate the haemodynamic effects of different CC depths in a neonatal piglet model.Methods: CCs were performed with an automated CC machine with 33%, 40% and 25% AP chest diameter in all piglets in the same order for a duration of 3 min each.Results: Eight newborn piglets (age 1-3 days, weight 1.7-2.3 kg) were included in the study. Carotid blood flow (CBF) and systolic blood pressure were the highest using a CC depth of 40% AP chest diameter (19.3±7.5 mL/min/kg and 58±32 mm Hg).Conclusion: CC depth influences haemodynamic parameters in asphyxiated newborn piglets during cardiopulmonary resuscitation. The highest CBF and systolic blood pressure were achieved using a CC depth of 40% AP chest diameter.Trial Registration Number: PCTE0000148. [ABSTRACT FROM AUTHOR]

Approximately 800,000 newborns die annually due to birth asphyxia. The resuscitation of asphyxiated term newly born infants often occurs unexpected and is challenging for healthcare providers as it demands experience and knowledge in neonatal resuscitation. Current neonatal resuscitation guidelines often focus on resuscitation of extremely and/or very preterm infants; however, the recommendations for asphyxiated term newborn infants differ in some aspects to those for preterm infants (i.e., respiratory support, supplemental oxygen, and temperature management). Since the update of the neonatal resuscitation guidelines in 2015, several studies examining various resuscitation approaches to improve the outcome of asphyxiated infants have been published. In this review, we discuss current recommendations and recent findings and provide an overview of delivery room management of asphyxiated term newborn infants. [ABSTRACT FROM AUTHOR]

Severe desaturation or bradycardia often occur during neonatal endotracheal intubation. Using continuous gas flow through the endotracheal tube might reduce the incidence of these events. We hypothesized that continuous gas flow through the endotracheal tube during nasotracheal intubation compared to standard nasotracheal intubation will reduce the number of intubation attempts in newborn infants. In a randomized controlled pilot study, neonates were either intubated with continuous gas flow through the endotracheal tube during intubation (intervention group) or no gas flow during intubation (control group). Recruitment was stopped early due to financial and organizational issues. A total of 16 infants and 39 intubation attempts were analyzed. The median (interquartile range) number of intubation attempts and number of abandoned intubations due to desaturation and/or bradycardia were 1 (1–2) and 4 (2–5), (p = 0.056) and n = 3 versus n = 20, (p = 0.060) in the intervention group and control group, respectively. Continuous gas flow through the endotracheal tube during intubation seems to be favorable and there are no major unexpected adverse consequences of attempting this methodology. [ABSTRACT FROM AUTHOR]

Body temperature (BT) management remains a challenge in neonatal intensive care, especially during resuscitation after birth. Our aim is to analyze whether there is an association between the BT and cerebral and peripheral tissue oxygen saturation (crSO2/cTOI and prSO2), arterial oxygen saturation (SpO2), and heart rate (HR). The secondary outcome parameters of five prospective observational studies are analyzed. We include preterm and term neonates born by Caesarean section who received continuous pulse oximetry and near-infrared spectroscopy monitoring during the first 15 min, and a rectal BT measurement once in minute 15 after birth. Four-hundred seventeen term and 169 preterm neonates are included. The BT did not correlate with crSO2/cTOI and SpO2. The BT correlated with the HR in all neonates (% = 0.210, p < 0.001) and with prSO2 only in preterm neonates (% = 0.285, p = 0.020). The BT was lower in preterm compared to term infants (36.7 [36.4-37.0] vs. 36.8 [36.6-37.0], p = 0.001) and prevalence of hypothermia was higher in preterm neonates (29.5% vs. 12.0%, p < 0.001). To conclude, the BT did not correlate with SpO2 and crSO2/cTOI, however, there was a weak positive correlation between the BT and the HR in the whole cohort and a weak correlation between the BT and prSO2 only in preterm infants. Preterm neonates had a statistically lower BT and suffered significantly more often from hypothermia during postnatal transition. [ABSTRACT FROM AUTHOR]

Aim: Cardiac function is a major factor for tissue perfusion and therefore may affect the tissue oxygen saturation. Aim was to analyse possible associations between cardiac function parameters and cerebral and peripheral tissue oxygenation in neonates on the first day after birth.Methods: For the present study, we analysed secondary outcome parameters of a previously performed prospective single centre observational study. The prospective study was conducted at the Medical University of Graz, Austria between September 2011 and June 2013. We included preterm and term neonates who were admitted to the neonatal intensive care unit and in whom simultaneous near-infrared spectroscopy measurements and echocardiography were obtained on the first day after birth. Cardiac function parameters were correlated to cerebral and peripheral tissue oxygen saturation and cerebral and peripheral fractional tissue oxygen extraction at the time of echocardiography.Results: A total of 60 neonates of whom 47 were preterm and 13 were term (median gestational age: 34; IQR 33-35 weeks, mean birth weight: 2276 ± 774 grams) were included. There were no statistically significant correlations between cardiac function parameters and regional tissue oxygenation parameters.Conclusion: In the present study, we found no correlation between regional tissue oxygenation and parameters of cardiac function in cardio-circulatory stable neonates on the first day after birth. [ABSTRACT FROM AUTHOR]

Background: Near-infrared spectroscopy (NIRS) combined with venous occlusions enables peripheral-muscle oxygenation and perfusion monitoring. Objective: The aim of the present exploratory observational study was to evaluate peripheral-muscle oxygenation and perfusion during the first 24 h after birth in stable preterm neonates. Approach: Secondary outcome parameters of prospective observational studies were analysed. Preterm neonates with peripheral-muscle NIRS measurements combined with venous occlusion on the first day after birth were included. Neonates without circulatory support and without signs of infection/inflammation were included. Neonates were stratified in four groups according to their measurement time-point (6 h-periods) and matched 2:1 for gestational age ±1 week. For each group haemoglobin flow (Hbflow), oxygen-delivery (DO2), oxygen-consumption (VO2), fractional-oxygen-extraction (FOE), tissue-oxygenation-index (TOI) and mixed-venous-oxygenation (SvO2) were calculated. Neonates with measurements during the first 6-hour time period were compared to neonates with measurements of the following time periods. Main results: 40 preterm neonates (gestational age (median(IQR)): 33.5(32.5–34.1)weeks) measured during the first 6 h period after birth were compared to 20 preterm neonates measured in each of the following 6 h periods (period two: 33.7(33.1–34.3)weeks; period three: 34.1(33.2–34.6)weeks; period four: 33.8(32.6–34.6)weeks). Hbflow, DO2 and SvO2 were significantly higher in the second and third 6 h time period compared to the first 6 h period. VO2 did not change significantly during the first day after birth. FOE was significantly lower in the second, third and fourth time period compared to the first 6 h period. TOI showed a non-significant trend towards higher values in the third period compared to the first 6 h period. Significance: In preterm neonates Hbflow, DO2, SvO2 increased, FOE decreased and TOI showed a trend towards increase during the first day after birth, whereas VO2 did not change. Changes of peripheral-muscle oxygenation during the first day after birth in stable preterm neonates are different to already published changes thereafter. [ABSTRACT FROM AUTHOR]

Background: Surfactant replacement is standard for preterm neonates with respiratory distress syndrome, improving survival and outcomes. Less invasive surfactant administration (LISA) and intubation-surfactant-extubation (INSURE) are preferred methods for surfactant replacement in spontaneously breathing preterm neonates. Despite the undeniable benefits of surfactant implementation in neonatal care, surfactant administration can affect vital parameters and cerebral oxygenation and perfusion, assessed by near-infrared spectroscopy (NIRS)., Objective: This review systematically examined the literature on surfactant administration in preterm neonates and its impact on NIRS-measured cerebral oxygenation., Methods: A systematic search of PubMed, Embase, CINAHL, Clinical Trials, and Ovid Medline was conducted using following terms: newborn, infant, neonate, preterm, premature, prematurity, surfactant, LISA, less-invasive surfactant administration, INSURE, near-infrared-spectroscopy, NIRS, oximetry, spectroscopy, cerebral oxygenation, cerebral tissue oxygen saturation (crSO 2 ), crSO 2 , cerebral perfusion. Only studies in human preterm neonates were included., Results: Sixteen studies were identified that described cerebral oxygenation measured by NIRS in the context of surfactant administration demonstrating a decrease in crSO 2 during surfactant administration, followed by a subsequent increase. Three studies specifically described the course of crSO 2 in neonates while receiving LISA, whereby in two of these LISA was compared to INSURE describing differences in crSO 2 behaviour. Two additional studies described surfactant administration using the INSURE procedure and the influence on cerebral oxygenation. Ten studies investigated surfactant administration in intubated neonates receiving mechanical ventilation. One study described crSO 2 in neonates receiving aerosolised surfactant., Conclusion: This systematic review indicates that surfactant administration is associated with a transient decrease in crSO 2 followed by a return to baseline levels, whereby differences between the LISA and INSURE methods were observed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: To compare chest compression (CC) rates of 60/min with 90/min and their effect on the time to return of spontaneous circulation (ROSC), survival, hemodynamic, and respiratory parameters. We hypothesized that asphyxiated newborn piglets that received CC at 60/min vs. 90/min during cardiopulmonary resuscitation would have a shorter time to ROSC., Methods: Newborn piglets ( n  = 7/group) were anesthetized, tracheotomized and intubated, instrumented and exposed to 45 min normocapnic hypoxia followed by asphyxia and cardiac arrest. Piglets were randomly allocated to a CC rate of 60/min or 90/min. CC was performed using an automated CC machine using CC superimposed with sustained inflation. Hemodynamic parameters, respiratory parameters, and applied compression force were continuously measured., Results: The mean (IQR) time to ROSC was 97 (65-149) s and 136 (88-395) s for CC rates of 60/min and 90/min, respectively ( p  = 0.31). The number of piglets that achieved ROSC was 5 (71%) and 5 (71%) with 60/min and 90/min CC rates, respectively ( p  = 1.00). Hemodynamic parameters (i.e., diastolic and mean blood pressure, carotid blood flow, stroke volume, end-diastolic volume, left ventricular contractile function) and respiratory parameters (i.e., minute ventilation, peak inflation and peak expiration flow) were all similar with a CC rate of 60/min compared to 90/min., Conclusion: Time to ROSC, hemodynamic, and respiratory parameters were not significantly different between CC rates of 60/min vs. 90/min. Different CC rates during neonatal resuscitation warrant further investigation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Bruckner, O'Reilly, Lee, Cheung and Schmölzer.)

Introduction: Maternal tobacco smoking during pregnancy is a global health problem leading to an increased risk for fetal and neonatal morbidities. So far, there are no data of the potential impact of maternal smoking during pregnancy on the most vulnerable period after birth - the immediate postnatal transition. The aim of the present study was therefore, to compare cerebral oxygenation during immediate postnatal transition in term neonates with and without prenatal tobacco exposure. Methods: Included in this post-hoc analysis were healthy term neonates, with measurements of cerebral oxygenation (INVOS 5100C) during the first 15 min after birth, and for whom information on maternal smoking behavior during pregnancy was available. Neonates with prenatal tobacco exposure (smoking group) were matched 1:1 according to gestational age (±1 week), birth weight (±100 grams) and hematocrit (±5 %) to neonates without (non-smoking group). Cerebral regional tissue oxygen saturation (crSO 2 ), cerebral fractional tissue oxygen extraction (cFTOE), arterial oxygen saturation (SpO 2 ) and heart rate (HR) within the first 15 min after birth were compared between the two groups. Results: Twelve neonates in the smoking group with a median (IQR) gestational age of 39.1 (38.8-39.3) weeks and a birth weight of 3,155 (2,970-3,472) grams were compared to 12 neonates in the non-smoking group with 39.1 (38.7-39.2) weeks and 3,134 (2,963-3,465) grams. In the smoking group, crSO 2 was significantly lower and cFTOE significantly higher until min 5 after birth. HR was significantly higher in the smoking group in min 3 after birth. Beyond this period, there were no significant differences between the two groups. Conclusion: Cerebral oxygenation within the first 5 min after birth was compromised in neonates with prenatal tobacco exposure. This observation suggests a higher risk for cerebral hypoxia immediately after birth due to fetal tobacco exposure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Wolfsberger, Bruckner, Schwaberger, Mileder, Pritisanac, Hoeller, Avian, Urlesberger and Pichler.)

Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition in preterm neonates. The secondary aim was to analyze the potential influence of FIRS on cerebral injury and mortality. Methods: Secondary outcome parameters of prospective observational studies were analyzed. Preterm neonates with measured IL-6 values from umbilical cord blood and cerebral near-infrared spectroscopy (NIRS) measurements during immediate transition after birth were included. Preterm neonates with FIRS (FIRS group) were matched 1:1 for gestational age (± 1 week) to preterm neonates without FIRS (non-FIRS group). crSO2, cFTOE, arterial oxygen saturation (SpO2), heart rate (HR), and fraction of inspired oxygen (FiO2) were compared between both groups. In addition, cerebral injury and mortality were compared between both groups. Results: A total of 46 preterm neonates were included. Twenty-three neonates in the FIRS group [median gestational age 32.1 (IQR 30.3-33.0) weeks; median IL-6 19.7 (IQR 12.2-37.0) pg/ml] were compared to 23 neonates in the non-FIRS group [gestational age: 32.0 (30.4-33.1) weeks; IL-6: 5.4 (3.0-6.7) pg/ml]. cFTOE showed significantly lower values within the first 4 min and a trend toward lower values in minute 5 after birth in the FIRS group. There were no significant differences in crSO2 within the first 15 min after birth between the two groups. SpO2 was significantly lower in minutes 5 and 6 and HR was significantly lower in minutes 2 and 4 after birth in the FIRS group compared to the non-FIRS group. Survival without cerebral injury was similar in both groups. Conclusion: In preterm neonates with FIRS the crSO2 was similar despite significantly lower cFTOE values during the first minutes after birth. This observation may be a result of compromised oxygen consumption and delivery in the first minutes after birth in neonates with FIRS., (Copyright © 2020 Wolfsberger, Bruckner, Baik-Schneditz, Schwaberger, Mileder, Avian, Urlesberger and Pichler.)

Background: Early nutritional support of preterm infants is important because it influences long-term health and development. Body composition has an influence on cardiovascular disease, metabolic syndrome, and neurocognitive outcome in the long term. Objective: To assess body composition in preterm infants <32 weeks of gestation at term-equivalent age and to analyze the influence of an optimized nutritional approach. Methods: This is a prespecified secondary outcome analysis of a prospective observational study comparing the body composition in regard to gestational age. The preterm infants were classified according to gestational age as extremely preterm infants (<28 weeks gestation at birth) and very preterm infants (≥28 weeks gestation at birth) and according to weight percentile as appropriate for gestational age and small for gestational age. Body composition was determined by air displacement plethysmography using the PEA POD. The preterm infants obtained nutrition according to the ESPGHAN 2010 Guidelines. Results: Seventy-four preterm infants were analyzed. The mean (SD) gestational age was 28.7 (2.4) weeks, and birth weight was 1,162 (372) g. Fat mass percentage was significantly higher in extremely preterm infants in comparison to very preterm infants [17.0, 95% confidence interval (CI) 15.9-18.1 vs. 15.5, 95% CI 14.7-16.2]. There was no significant difference of fat mass percentage according to weight percentiles. Conclusions: Extremely preterm infants had a significantly higher fat mass percentage compared to very preterm infants at term-equivalent age. There was no significant difference of fat mass percentage according to weight percentiles., (Copyright © 2020 Bruckner, Khan, Binder, Morris, Windisch, Holasek and Urlesberger.)

Background: According to recommendations, non-invasive monitoring during neonatal resuscitation after birth includes heart rate (HR) and oxygen saturation (SpO 2 ). Continuous transcutaneous monitoring of carbon dioxide partial pressure (tcpCO 2 ) may further offer quantitative information on neonatal respiratory status. Objective: We aimed to investigate feasibility of tcpCO 2 measurements in the delivery room during immediate neonatal transition and to compare the course of tcpCO 2 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 SpO 2 by pulse oximetry on the right wrist and tcpCO 2 with the sensor applied on the left hemithorax during the first 15 min after birth. Courses of tcpCO 2 were analyzed in term and preterm neonates and groups were compared. Results: Fifty-three term (gestational age: 38.8 ± 0.9 weeks) and 13 preterm neonates (gestational age: 34.1 ± 1.5 weeks) were included. First tcpCO 2 values were achieved in both groups at minute 4 after birth, which reached a stable plateau after the equilibration phase at minute 9. Mean tcpCO 2 values 15 min after birth were 46.2 (95% CI 34.5-57.8) mmHg in term neonates and 48.5 (95%CI 43.0-54.1) mmHg in preterm neonates. Preterm and term infants did not show significant differences in the tcpCO 2 values at any time point. Conclusion: This study demonstrates that tcpCO 2 measurement is feasible during immediate neonatal transition after birth and that tcpCO 2 values were comparable in stable term and preterm neonates., (Copyright © 2020 Bresesti, Bruckner, Mattersberger, Baik-Schneditz, Schwaberger, Mileder, Avian, Urlesberger and Pichler.)