Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates.
BACKGROUND
Diagnosis of necrotizing enterocolitis (NEC) in preterm neonates is challenging. We hypothesized that regional splanchnic oxygen saturation (rsSO₂) measured by near-infrared spectroscopy (NIRS) is a biomarker for mesenteric perfusion.


OBJECTIVE
To evaluate feasibility and safety of continuous rsSO₂ monitoring in preterm infants in the first 14 days of life.


METHODS
Preterm neonates ≤30 weeks' gestation had a NIRS sensor placed in the left paraumbilical region within 48 h of birth. rsSO₂ was recorded every 30 s. Clinical data including pulse oximetry (SaO₂) were recorded. Fractional tissue oxygen extraction (FTOE) was computed as follows: (SaO₂ - rsSO₂) × 100/SaO₂.


RESULTS
Of 21 infants enrolled, 2 were excluded because of skin breakdown and missing data. Daily mean rsSO₂ values decreased over the first 9 days (p < 0.0001) followed by an increase from day 10 (D10) to D14 (p = 0.0061). rsSO(2) was lower and FTOE was higher in infants with feeding intolerance compared to those without feeding intolerance (p = 0.0043). rsSO₂ accounted for ≥99.5% of the variance in FTOE. Two neonates with NEC had persistently low rsSO₂ with loss of variability preceded or followed by very high rsSO₂.


CONCLUSIONS
We have reported feasibility, safety and ranges for rsSO₂ for a small number of preterm infants in the first 2 weeks of life.
Cortez
Josef
J
Division of Neonatal-Perinatal Medicine,Wayne State University and Children's Hospital of Michigan, Detroit, Michigan 48201, USA.
Gupta
Meenakshi
M
Amaram
Arun
A
Pizzino
Janet
J
Sawhney
Megha
M
Sood
Beena G
BG
D001784:Blood Gas Analysis / Q000379:methods; D005240:Feasibility Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000032:analysis / Q000378:metabolism; D010101:Oxygen Consumption / Q000502:physiology; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D013152:Splanchnic Circulation / Q000502:physiology
D010100:Oxygen