Abstract:Objective To study the changing trend of abdominal regional oxygen saturation (A-rSO2) in very/extremely low birth weight (VLBW/ELBW) infants after birth. Methods The VLBW/ELBW infants who were admitted to the neonatal intensive care unit from September 2019 to May 2021 were enrolled as subjects. Near-infrared spectroscopy was used to monitor A-rSO2 since day 1 after birth for 4 weeks. According to gestational age, the infants were divided into a low gestational age (<29 weeks) group and a high gestational age (≥29 weeks) group. The two groups were compared in terms of A-rSO2 within 4 weeks after birth. Results A total of 63 VLBW/ELBW infants were enrolled, with 30 infants in the <29 weeks group and 33 in the ≥29 weeks group. A-rSO2 fluctuated within the first 2 weeks after birth in the 63 infants and had the lowest level of 47.9% on day 1 after birth and then gradually increased, reaching the peak level of 67.4% on day 4; it gradually decreased on days 5-9, then gradually increased, and became relatively stable 2 weeks after birth. The ≥29 weeks group had significantly higher A-rSO2 than the <29 weeks group at weeks 1 and 2 after birth (P<0.05), while there was no significant difference in A-rSO2 between the two groups at weeks 3 and 4 after birth (P>0.05). Conclusions In infants with VLBW/ELBW, A-rSO2 fluctuates within the first 2 weeks after birth and then gradually becomes stable. A-rSO2 is associated with gestational age within 2 weeks after birth.
ZHANG Jing-Hua,GUAN Rui-Lian,PAN Pian-Pian et al. Changing trend of abdominal regional oxygen saturation in very/extremely low birth weight infants in the early postnatal stage: a prospective study[J]. CJCP, 2021, 23(10): 1015-1020.
Ghanayem NS, Hoffman GM. Near infrared spectroscopy as a hemodynamic monitor in critical illness[J]. Pediatr Crit Care Med, 2016, 17(8 Suppl 1): S201-S206. PMID: 27490600. DOI: 10.1097/PCC.0000000000000780.
Sathish N, Singh NG, Nagaraja PS, et al. Comparison between noninvasive measurement of central venous pressure using near infrared spectroscopy with an invasive central venous pressure monitoring in cardiac surgical intensive care unit[J]. Ann Card Anaesth, 2016, 19(3): 405-409. PMID: 27397443. PMCID: PMC4971967. DOI: 10.4103/0971-9784.185520.
van der Heide M, Hulscher JBF, Bos AF, et al. Near-infrared spectroscopy as a diagnostic tool for necrotizing enterocolitis in preterm infants[J]. Pediatr Res, 2021,90(1):148-155. PMID: 33036017. DOI: 10.1038/s41390-020-01186-8.
Al-Hamad S, Hackam DJ, Goldstein SD, et al. Contrast-enhanced ultrasound and near-infrared spectroscopy of the neonatal bowel: novel, bedside, noninvasive, and radiation-free imaging for early detection of necrotizing enterocolitis[J]. Am J Perinatol, 2018, 35(14): 1358-1365. PMID: 29852509. DOI: 10.1055/s-0038-1655768.
Eaton S, Rees CM, Hall NJ. Current research on the epidemiology, pathogenesis, and management of necrotizing enterocolitis[J]. Neonatology, 2017, 111(4): 423-430. PMID: 28538238. DOI: 10.1159/000458462.
Seager E, Longley C, Aladangady N, et al. Measurement of gut oxygenation in the neonatal population using near-infrared spectroscopy: a clinical tool?[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(1): 76-86. PMID: 31154420. DOI: 10.1136/archdischild-2018-316750.
Patel AK, Lazar DA, Burrin DG, et al. Abdominal near-infrared spectroscopy measurements are lower in preterm infants at risk for necrotizing enterocolitis[J]. Pediatr Crit Care Med, 2014, 15(8): 735-741. PMID: 25068253. DOI: 10.1097/PCC.0000000000000211.
Cortez J, Gupta M, Amaram A, et al. Noninvasive evaluation of splanchnic tissue oxygenation using near-infrared spectroscopy in preterm neonates[J]. J Matern Fetal Neonatal Med, 2011, 24(4): 574-582. PMID: 20828232. DOI: 10.3109/14767058.2010.511335.
McNeill S, Gatenby JC, McElroy S, et al. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants[J]. J Perinatol, 2011, 31(1): 51-57. PMID: 20539273. PMCID: PMC3013378. DOI: 10.1038/jp.2010.71.
Benitz WE, Committee on Fetus and Newborn, American Academy of Pediatrics. Patent ductus arteriosus in preterm infants[J]. Pediatrics, 2016, 137(1): e20153730. PMID: 26672023. DOI: 10.1542/peds.2015-3730.
Ledo A, Aguar M, Nú?ez-Ramiro A, et al. Abdominal near-infrared spectroscopy detects low mesenteric perfusion early in preterm infants with hemodynamic significant ductus arteriosus[J]. Neonatology, 2017, 112(3): 238-245. PMID: 28704836. DOI: 10.1159/000475933.
Bailey SM, Hendricks-Munoz KD, Mally P. Cerebral, renal, and splanchnic tissue oxygen saturation values in healthy term newborns[J]. Am J Perinatol, 2014, 31(4): 339-344. PMID: 23873114. DOI: 10.1055/s-0033-1349894.
Schneider A, Minnich B, Hofst?tter E, et al. Comparison of four near-infrared spectroscopy devices shows that they are only suitable for monitoring cerebral oxygenation trends in preterm infants[J]. Acta Paediatr, 2014, 103(9): 934-938. PMID: 24847771. DOI: 10.1111/apa.12698.
Nankervis CA, Nowicki PT. Role of nitric oxide in regulation of vascular resistance in postnatal intestine[J]. Am J Physiol, 1995, 268(6 Pt 1): G949-G958. PMID: 7611416. DOI: 10.1152/ajpgi.1995.268.6.G949.
Nankervis CA, Nowicki PT. Role of endothelin-1 in regulation of the postnatal intestinal circulation[J]. Am J Physiol Gastrointest Liver Physiol, 2000, 278(3): G367-G375. PMID: 10712255. DOI: 10.1152/ajpgi.2000.278.3.G367.
Nankervis CA, Dunaway DJ, Nowicki PT. Determinants of terminal mesenteric artery resistance during the first postnatal month[J]. Am J Physiol Gastrointest Liver Physiol, 2001, 280(4): G678-G686. PMID: 11254494. DOI: 10.1152/ajpgi.2001.280.4.G678.
Schat TE, van Zoonen AGJF, van der Laan ME, et al. Early cerebral and intestinal oxygenation in the risk assessment of necrotizing enterocolitis in preterm infants[J]. Early Hum Dev, 2019, 131: 75-80. PMID: 30870625. DOI: 10.1016/j.earlhumdev.2019.03.001.