Multicenter observational study on noninvasive gastrointestinal tissue oxygen saturation measurement using near infrared spectroscopy in left colorectal surgery.
Ontology highlight
ABSTRACT:
DISEASE(S): Colorectal Cancer
PROVIDER: 2653069 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
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Project description:Near-infrared spectroscopy (NIRS) measures oxygen metabolism and is increasingly used for monitoring critically ill neonates. The implications of NIRS-recorded data in this population are poorly understood. We evaluated NIRS monitoring for neonates with seizures.In neonates monitored with video-electroencephalography, NIRS-measured cerebral regional oxygen saturation (rSO2) and systemic O2 saturation were recorded every 5 s. Mean rSO2 was extracted for 1-h blocks before, during, and after phenobarbital doses. For each electrographic seizure, mean rSO2 was extracted for a period of three times the duration of the seizure before and after the ictal pattern, as well as during the seizure. Linear mixed models were developed to assess the impact of phenobarbital administration and of seizures on rSO2 and fractional tissue oxygen extraction.For 20 neonates (estimated gestational age: 39.6?±?1.5?wk), 61 phenobarbital doses and 40 seizures were analyzed. Cerebral rSO2 rose (P = 0.005), and fractional tissue oxygen extraction declined (P = 0.018) with increasing phenobarbital doses. rSO2 declined during seizures, compared with baseline and postictal phases (baseline 81.2 vs. ictal 77.7 vs. postictal 79.4; P = 0.004). Fractional tissue oxygen extraction was highest during seizures (P = 0.002).Cerebral oxygen metabolism decreases after phenobarbital administration and increases during seizures. These small, but clear, changes in cerebral oxygen metabolism merit assessment for potential clinical impact.
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Project description:BackgroundPeripheral fractional oxygen extraction (pFOE) measured with near-infrared spectroscopy (NIRS) in combination with venous occlusion is of increasing interest in term and preterm neonates.ObjectiveThe aim was to perform a systematic qualitative review of literature on the clinical use of pFOE in term and preterm neonates and on the changes in pFOE values over time.MethodsA systematic search of PubMed, Embase and Medline was performed using following terms: newborn, infant, neonate, preterm, term, near-infrared spectroscopy, NIRS, oximetry, spectroscopy, tissue, muscle, peripheral, arm, calf, pFOE, OE, oxygen extraction, fractional oxygen extraction, peripheral perfusion and peripheral oxygenation. Additional articles were identified by manual search of cited references. Only studies in human neonates were included.ResultsNineteen studies were identified describing pFOE measured with NIRS in combination with venous occlusion. Nine studies described pFOE measured on the forearm and calf at different time points after birth, both in stable preterm and term neonates without medical/respiratory support or any pathological findings. Nine studies described pFOE measured at different time points in sick preterm and term neonates presenting with signs of infection/inflammation, anemia, arterial hypotension, patent ductus arteriosus, asphyxia or prenatal tobacco exposure. One study described pFOE both, in neonates with and without pathological findings.ConclusionThis systematic review demonstrates that pFOE may provide additional insight into peripheral perfusion and oxygenation, as well as into disturbances of microcirculation caused by centralization in preterm and term neonates with different pathological findings.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42021249235].
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