Changes in regional tissue oxygen saturation values during the first week of life in stable preterm infants

Sadaf H. Kazmi; Sourabh Verma; Sean M. Bailey; Pradeep Mally; Purnahamsi Desai

doi:10.1515/jpm-2023-0243

Article

Changes in regional tissue oxygen saturation values during the first week of life in stable preterm infants

Sadaf H. Kazmi , Sourabh Verma , Sean M. Bailey , Pradeep Mally and Purnahamsi Desai

Published/Copyright: March 5, 2024

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From the journal Journal of Perinatal Medicine Volume 52 Issue 4

Abstract

Objectives

Near infrared spectroscopy (NIRS) is a non-invasive method for monitoring regional tissue oxygen saturation (rSO₂). The purpose of this study is to investigate the changes that occur in cerebral, splanchnic, and renal rSO₂ and fractional tissue oxygen extraction (FTOE) in stable preterm infants in the first week of life.

Methods

Prospective observational study of infants born 30–34 weeks gestation at NYU Langone Health between November 2017 and November 2018. Cerebral, renal, and splanchnic rSO₂ were monitored from 12 to 72 h of life, and at seven days. Subjects were divided into gestational age (GA) cohorts. Average rSO₂, splanchnic cerebral oxygen ratio (SCOR), FTOE, and regional intra-subject variability was calculated at each location at five different time intervals: 0–12 h, 12–24 h, 24–48 h, 48–72 h, and one week of life.

Results

Twenty subjects were enrolled. The average cerebral rSO₂ ranged from 76.8 to 92.8 %, renal rSO₂ from 65.1 to 91.1 %, and splanchnic rSO₂ from 36.1 to 76.3 %. The SCOR ranged from 0.45 to 0.94. The strongest correlation between the GA cohorts was in the cerebral region (R²=0.94) and weakest correlation was in the splanchnic region (R²=0.81). The FTOE increased in all three locations over time. Intra-subject variability was lowest in the cerebral region (1.3 % (±1.9)).

Conclusions

The cerebral region showed the strongest correlation between GA cohorts and lowest intra-subject variability, making it the most suitable for clinical use when monitoring for tissue hypoxia. Further studies are needed to further examine rSO₂ in preterm infants.

Keywords: near infrared spectroscopy; preterm infants; regional tissue oxygen saturation; splanchnic cerebral oxygenation ratio; fractional tissue oxygen extraction

Corresponding author: Sadaf H. Kazmi, MD, Assistant Professor of Pediatrics, Department of Pediatrics, Hassenfeld Children’s Hospital of New York University Langone Health Center, 317 East 34th St, Suite 902, New York, NY 10016, USA; and New York University Grossman School of Medicine, New York, NY, USA, Phone: 212 263 7950, E-mail: sadaf.kazmi@nyulangone.org

Funding source: Kids of NYU Langone

Award Identifier / Grant number: 51-C49550-72475-NYUPRJ

Acknowledgments

The authors would like to acknowledge the KiDS of NYU Langone Foundation for providing funding for this study as well as the families of the preterm infants in our study.

Research ethics: Research involving human subjects complied with all relevant national regulations, institutional policies and is in accordance with the tenets of the Helsinki Declaration (as revised in 2013) and has been approved by the authors’ Institutional Review Board (# i16-01983).
Informed consent: Informed consent was obtained from all individuals included in this study.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Dr. Bailey is a member of the Medtronic speaker’s bureau. All other authors state no conflict of interest.
Research funding: This work was funded by KiDS of NYU Langone Foundation, Grant #51-C49550-72475-NYUPRJ.
Data availability: The raw data can be obtained on request from the corresponding author.

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Received: 2023-06-14

Accepted: 2024-01-28

Published Online: 2024-03-05

Published in Print: 2024-05-27

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Articles in the same Issue

https://doi.org/10.1515/jpm-2023-0243

Keywords for this article

near infrared spectroscopy; preterm infants; regional tissue oxygen saturation; splanchnic cerebral oxygenation ratio; fractional tissue oxygen extraction