Near-infrared spectroscopy in the detection of regional tissue oxygenation during hypoxic events in preterm infants undergoing critical care
- 1 September 2006
- journal article
- Published by Wolters Kluwer Health in Pediatric Critical Care Medicine
- Vol. 7 (5), 449-454
- https://doi.org/10.1097/01.pcc.0000235248.70482.14
Abstract
To determine whether pulse oximetry-detected episodes of desaturation are associated with impairment of cerebral and somatic (renal) tissue oxygenation in mechanically ventilated preterm neonates. Observational cross-sectional study. Neonatal intensive care unit of a university-affiliated children's hospital. Ten mechanically ventilated preterm (gestational age 24-32 wks) infants. In addition to the traditional monitoring of hemodynamic variables that included pulse oximetry (Sao2), near-infrared spectroscopy (NIRS) was used to evaluate the cerebral and somatic (renal) tissue oxygen saturation (rSO2C and rSO2R, respectively). A total of 40 rSO2C and rSO2R measurements were simultaneously recorded: 20 during hypoxic events when the Sao2 was /=4 secs (cases) and generally ranged between 70% and 80%, and 20 measurements when the Sao2 was >/=85% (paired controls). Additionally, the fractional oxygen extraction (FOE) from the cerebral (FOEC) and renal (FOER) tissue was calculated. All the measurements were made under steady conditions during a 2-hr period. The rSO2C, rSO2R, FOEC, and FOER among the cases (Sao2 /= 85%) were compared using the paired Student's t-test. Both rSO2C and rSO2R during the desaturation episodes were lower than in the controls (51.6 +/- 6.3% vs. 66.2 +/- 10.2%, p < .0001 and 61.1 +/- 6.8% vs. 80.1 +/- 10.0%, p < .0001, respectively). The FOEC during the hypoxic episodes was comparable with control levels but increased in renal tissue. However, during two of the desaturation episodes (10%), the rSO2C and FOEC levels (which were 0.47, respectively) may reflect compromised tissue oxygen supply. In the majority of mechanically ventilated preterm neonates, the reduction in cerebral and renal tissue oxygenation associated with short periods of decreased arterial saturation to 70-80% does not significantly compromise oxygen utilization in the cerebral tissue but increases oxygen extraction in the renal tissue, which might cause ischemic tissue injury following a further reduction in oxygen delivery.Keywords
This publication has 40 references indexed in Scilit:
- A noninvasive estimation of mixed venous oxygen saturation using near‐infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patientsPediatric Anesthesia, 2005
- Near‐infrared spectroscopic cerebral oxygenation reading in neonates and infants is associated with central venous oxygen saturationPediatric Anesthesia, 2005
- Effect of blood transfusions on cerebral haemodynamics in preterm infantsActa Paediatrica, 2002
- Regionale transkranielle Oxymetrie mit Nahinfrarot-Spektroskopie (NIRS) im Vergleich zur Messung der Sauerstoffsättigung im Bulbus jugularis bei Säuglingen und Kindern als Monitoring der zerebralen Oxygenierung - Comparison of Regional Transcranial Oximetry with Near Infrared Spectroscopy (NIRS) and Jugular Venous Bulb Oxygen Saturation for the Monitoring of Cerebral Oxygenation in Infants and ChildrenBiomedizinische Technik/Biomedical Engineering, 2000
- Low cerebral blood flow is a risk factor for severe intraventricular haemorrhageArchives of Disease in Childhood: Fetal & Neonatal, 1999
- HEMOGLOBIN OXYGENATION KINETICS AND SECONDARY ISCHEMIA IN RENAL TRANSPLANTATION1Transplantation, 1996
- Effect of the arterial oxygenation level on cardiac output, oxygen extraction, and oxygen consumption in low birth weight infants receiving mechanical ventilationThe Journal of Pediatrics, 1995
- Near-Infrared spectroscopy in newborn infantsBrain & Development, 1992
- Arterial oxygen saturation in preterm infants at discharge from the hospital and six weeks laterThe Journal of Pediatrics, 1992
- Blood pressure and cerebral ischemia in very low birth weight infantsThe Journal of Pediatrics, 1990