Abstract
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). rsSO2 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.
Acknowledgements
We gratefully acknowledge the assistance of Barbara Maynarich, Information Resources Technician, and Cathy Eames, M.S.L.S. in searching the medical literature and preparing the bibliography. This study was supported by Children's Research Center of Michigan and Somanetics Corporation (Troy, MI, USA). The results reported in this manuscript were presented in part at the Pediatric Academic Societies' Annual Meeting on May 2, 2009 at Baltimore, Maryland.