C reactive protein: impact on peripheral tissue oxygenation and perfusion in neonates

Abstract

Inflammatory processes with CRP elevation cause impaired peripheral oxygenation and perfusion in neonates even when routine haemodynamic variables are still normal. NIRS might offer a new non-invasive tool for the early recognition and diagnosis of infectious and non-infectious inflammatory processes.

Peripheral Muscle Near-Infrared Spectroscopy in Neonates: Ready for Clinical Use? A Systematic Qualitative Review of the Literature

“…They found lower values of TOI, oxygenated and deoxygenated haemoglobin and blood volume in the affected limb compared to the unaffected one. Nonetheless, the TOI values in the unaffected group were also low compared to other studies [1,3,13,14,15,17,18,19,27]. We can only speculate on this observation.…”

“…All 41 studies performed peripheral muscle NIRS measurements in human neonates. Twenty-one studies were identified to use peripheral muscle NIRS measurements as a single method [1,3,6,7,8,9,10,11,12,13,14,15,16,17,18,19,23,24,25,27,28] (table 1), 17 studies combined cerebral and peripheral muscle NIRS measurements [20,21,22,29,30,31,32,33,34,35,36,37,38,39,40,41,42] (table 2) and 1 study used multi-site NIRS measurements [43] (table 2) in human neonates. Two randomized studies were identified [12,36].…”

“…Peripheral muscle NIRS measurements can be combined with the venous occlusion [1,3,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22] and arterial occlusion methods [6,7]. With venous occlusion it is possible (due to the undisturbed arterial inflow to the extremity and the interrupted venous outflow) to measure blood flow and venous oxygen saturation (SvO 2 ).…”

“…Many studies have been published trying to demonstrate the potential usefulness of peripheral muscle NIRS measurements in the diagnosis and treatment of neonates using either the arterial [6,7] or the venous occlusion method [1,3,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22] or both [23,24,25]. The aim of this work was to perform a systematic qualitative review on peripheral muscle NIRS measurements in the clinical care of term and preterm neonates.…”

Leukocytes influence peripheral tissue oxygenation and perfusion in neonates

“…(11)(12)(13) Recently, our study group was able to show differences in peripheral oxygenation and perfusion in neonates with CRP elevation. (14) The aim of this study was to demonstrate a possible association between varying leukocyte counts and peripheral tissue oxygenation/perfusion measured with NIRS in term and preterm neonates. We hypothesized that peripheral oxygenation and perfusion would be impaired in association with increasing leukocyte counts.…”