Near‐infrared spectroscopy is a promising noninvasive technique for monitoring the effects of feeding regimens on the cerebral and splanchnic regions

Grometto, Alice; Pizzo, Benedetta; Strozzi, Maria Chiara; Gazzolo, Francesca; Gazzolo, Diego

doi:10.1111/apa.14099

Cited by 15 publications

(16 citation statements)

References 22 publications

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“…R s SO 2 has also been studied to guide nutritional management, to investigate the effect of anemia and blood transfusions, and to examine the effect of various medications such as ibuprofen on splanchnic oxygenation. [9][10][11][12][13][14][15] However, the use of r s SO 2 in clinical care is currently limited, in part due to a lack of solid reference values. 16,17 Only a few studies in small samples are available as basis for the current reference values.…”

Section: Introductionmentioning

confidence: 99%

Regional splanchnic oxygen saturation for preterm infants in the first week after birth: reference values

et al. 2021

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BACKGROUND: Near-infrared spectroscopy is used in the assessment of regional splanchnic oxygen saturation (r s SO 2 ), but solid reference values are scarce. We aimed to establish reference values of r s SO 2 for preterm infants during the first week after birth, both crude and modeled based on predictors. METHODS: We included infants with gestational age (GA) <32 weeks and/or birth weight <1200 g. We excluded infants who developed necrotizing enterocolitis or sepsis or who died. In the first week after birth, we determined a daily 2-h mean of r s SO 2 to assess its associations with sex, GA, postnatal age (PNA), small-for-gestational age (SGA) status, patent ductus arteriosus, hemoglobin, nutrition, and head circumference at birth and translated those into a prediction model. RESULTS: We included 220 infants. On day 1, the mean ± SD r s SO 2 value was 48.2% ± 16.6. The nadir of r s SO 2 was on day 4 (38.7% ± 16.6 smoothed line) to 5 (37.4%±17.3, actual data), after which r s SO 2 increased to 44.2% ± 16.6 on day 7. The final model of the reference values of r s SO 2 included the following coefficients: r s SO 2 = 3.2 − 7.0 × PNA + 0.8 × PNA 2 − 4.0 × SGA + 1.8 × GA. CONCLUSIONS: We established reference values of r s SO 2 for preterm infants during the first week after birth. GA, PNA, and SGA affect these values and need to be taken into account.

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Section: Introductionmentioning

confidence: 99%

Regional splanchnic oxygen saturation for preterm infants in the first week after birth: reference values

et al. 2021

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“…SCOR mirrors the splanchnic oxygenation status associated with acute abdomen, feeding, and IUGR status 3,4,12,13,40–43 . based on the principle that cerebral StO 2 remains unchanged due to cerebral autoregulation at the cost of variable splanchnic StO 2 .…”

Section: Discussionmentioning

confidence: 99%

“…19 SCOR mirrors the splanchnic oxygenation status associated with acute abdomen, feeding, and IUGR status. 3,4,12,13,[40][41][42][43] based on the principle that cerebral StO 2 remains unchanged due to cerebral autoregulation at the cost of variable splanchnic StO 2 . Accordingly, a decrease in SCOR indicates splanchnic ischemia (e.g., acute abdomen, 3 IUGR 13,40 ), whereas an increase in SCOR suggests splanchnic hyperemia (e.g., post-feeds 4,12,[41][42][43] ) However, our findings suggested that in association with PRBCT, a decrease in SCOR suggests improvement in cerebral tissue oxygenation rather than deterioration in splanchnic tissue oxygenation.…”

Section: Demographic Featuresmentioning

confidence: 99%

Splanchnic‐cerebral oxygenation ratio associated with packed red blood cell transfusion in preterm infants

Balegar

Jayawardhana

Chazal

et al. 2022

Transfusion Medicine

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Background: Splanchnic-cerebral oxygenation ratio (SCOR), the ratio of splanchnic tissue oxygen (StO 2 s) to simultaneously measured cerebral tissue oxygen (StO 2 c), has been described as a surrogate to detect impaired splanchnic oxygenation associated with hypoperfusion status such as necrotizing enterocolitis. This concept is based on the presumption that any change in SCOR indicates a corresponding change in splanchnic tissue oxygenation as the numerator, whereas cerebral tissue oxygenation as the denominator remains stable. However, it is questionable to utilise this concept to detect splanchnic oxygenation changes in the context of packed red blood cell transfusion (PRBCT).Aim: The current study examines the contribution of both cerebral and splanchnic oxygenation components to PRBCT-associated SCOR changes in preterm infants.Design: Prospective cohort study.Setting: Neonatal intensive care.Patients: Hemodynamically stable infants: Gestation <32 weeks; birth weight <1500 g; postmenstrual age <37 weeks: tolerating ≥120 ml/kg/day feed volume.Interventions: PRBCT at 15 ml/kg, over 4 h.Main Outcome Measures: Transfusion-associated changes were determined by performing mixed models for repeated measures analysis between the 4-h mean pretransfusion values (SCOR 0, StO 2 s 0, and StO 2 c 0) and the post-transfusion hourly mean values for the next 28 h (SCOR 1-28, StO 2 s 1-28, and StO 2 c 1-28). Dunnett's method was used to adjust for the multiplicity of the p value.Results: Of 30 enrolled infants 14 [46.7%] male; median [IQR] birth weight, 923 [655-1064] g; gestation, 26.4 [25.5-28.1] weeks; enrolment weight, 1549 [1113-1882] g; and postmenstrual age, 33.6 [32.4-35.0] weeks, one infant was excluded because of corrupted NIRS data. With the commencement of PRBCT, SCOR demonstrated a downward trend throughout the study period. This drift was associated with an increasing StO 2 c trend, while StO 2 s remained unchanged throughout the study period.

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“…Lastly, it should be noted that OMT and NIRS recordings were performed at least 1 h before or after feeding in order to avoid potential bias effects due to feeding regimens [33]. Yet, this possibility was avoided since each case acted as his or her own control.…”

Section: Discussionmentioning

confidence: 99%

Osteopathic Manipulation Treatment Improves Cerebro–splanchnic Oximetry in Late Preterm Infants

Marinelli¹,

Pluchinotta

Cozzolino³

et al. 2019

Molecules

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Background: To evaluate the effectiveness/side-effects of osteopathic manipulation treatment (OMT) performed on the 7th post-natal day, on cerebro–splanchnic oximetry, tissue activation and hemodynamic redistribution in late preterm (LP) infants by using near infrared spectroscopy (NIRS). Methods: Observational pretest-test study consisting in a cohort of 18 LPs who received OMT on the 7th post-natal day. NIRS monitoring was performed at three different time-points: 30 min before (T0), (30 min during (T1) and 30 min after OMT (T2). We evaluated the effects of OMT on the following NIRS parameters: cerebral (c), splanchnic (s) regional oximetry (rSO2), cerebro–splanchnic fractional tissue oxygen extraction (FTOE) and hemodynamic redistribution (CSOR). Results: crSO2 and cFTOE significantly (P < 0.001) improved at T0-T2; srSO2 significantly (P < 0.001) decreased and sFTOE increased at T0-T1. Furthermore, srSO2 and sFTOE significantly improved at T1-T2. Finally, CSOR significantly (P < 0.05) increased at T0-T2. Conclusions: The present data show that OMT enhances cerebro–splanchnic oximetry, tissue activation and hemodynamic redistribution in the absence of any adverse clinical or laboratory pattern. The results indicate the usefulness of further randomized studies in wider populations comparing the effectiveness of OMT with standard rehabilitation programs.

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Near‐infrared spectroscopy is a promising noninvasive technique for monitoring the effects of feeding regimens on the cerebral and splanchnic regions

Cited by 15 publications

References 22 publications

Regional splanchnic oxygen saturation for preterm infants in the first week after birth: reference values

Regional splanchnic oxygen saturation for preterm infants in the first week after birth: reference values

Splanchnic‐cerebral oxygenation ratio associated with packed red blood cell transfusion in preterm infants

Osteopathic Manipulation Treatment Improves Cerebro–splanchnic Oximetry in Late Preterm Infants

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