title: Near-infrared spectroscopy measure of limb peripheral perfusion in neonatal arterial thromboembolic disease.
abstract: OBJECTIVE
  In critically ill neonates, peripheral perfusion and oxygenation assessment may provide indirect information on circulatory failure in limb arterial thromboembolic emergencies. Aims of our study were: 1) to evaluate the changes on tissue oxygenation index, oxyhemoglobin, deoxyhemoglobin and blood volume obtained by near-infrared spectroscopy (NIRS) on the infants legs; 2) to compare them with ultrasonographic data.
  
  
  METHODS
  Tissue oxygenation index (TOI), oxyhemoglobin (O2Hb), deoxyhemoglobin (HHb) and blood volume (BV) differences were assessed by NIRS on the calf of 8 newborn infants (median weight 1995, range 585-3010 g; median gestational age 32.5, range 26-40 wks). An ultrasonographic scan of the arterial system was performed before the NIRS measurements, to validate the site of arterial occlusion.
  
  
  RESULTS
  A t-test for independent samples showed lower values in the affected limb for all NIRS measurements. TOI measurements displayed lower values in the thromboembolic limb (mean 44.79±12%) versus unaffected (mean 47.95±17.08%) (P=0.0001). Mean (SD) peak systolic velocity in the patent artery below the occlusion decreased from 108±25 cm/s in the normal limb to 25.6±28 cm/s in the thrombus site (P=0.02).
  
  
  CONCLUSIONS
  In neonatal intensive care units, measurement of limb peripheral perfusion and oxygenation seems to be clinically useful in arterial thromboembolic emergencies.
authors.affiliation: Department of Women and Children's Health, University of Padua, Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Milan
authors.forename: F
authors.initials: F
authors.lastname: Freato
authors.forename: V
authors.initials: V
authors.lastname: Vanzo
authors.forename: G
authors.initials: G
authors.lastname: Camporese
authors.forename: M
authors.initials: M
authors.lastname: Baraldi
authors.forename: L
authors.initials: L
authors.lastname: Chiandetti
authors.forename: P
authors.initials: P
authors.lastname: Zaramella
mesh_terms: D005121:Extremities / Q000098:blood supply*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012039:Regional Blood Flow; D019265:Spectroscopy, Near-Infrared; D013923:Thromboembolism / Q000503:physiopathology*