Peripheral Oxygenation in Preterm Infants

Wardle, Stephen P.; Weindling, A M

doi:10.1016/s0095-5108(18)30028-9

Cited by 13 publications

(8 citation statements)

References 68 publications

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“…Given the lack of other noninvasive methods, NIRS has been the only bedside clinical tool available in the last few years for evaluating muscle circulatory status in healthy and sick neonates and many significant clinical studies have been published. [8][9][10][11][12]16,18,22,25 NIRS was combined in our study with arterial/venous occlusion maneuvers to measure local muscle BF, VO 2 , and SvO 2 . 9,10,22 Using this NIRS approach, FOE proved to be a better indicator of the need for transfusion in anemia than hemoglobin concentration.…”

Section: Discussionmentioning

confidence: 99%

“…15 During venous occlusion, hemoglobin flow (Hb flow) equates to the rate of tissue Hb accumulation during the initial part of the occlusion. The Hb flow was calculated, according to Wardle and Weindling, 8 NIRS and Arterial Occlusion to Calculate VO 2 The cuff was inflated rapidly on the thigh to 100 mmHg for 30 to 40 seconds to obtain an arterial occlusion; VO 2 was calculated from the rate at which O 2 Hb changes to HHb during the first 3 seconds ¼ R DO 2 Hb dt. 10,17 The interval between occlusions was set at 5 minutes to ensure a sufficient recovery period.…”

Section: Nirs and Venous Occlusion To Calculate Blood Flowmentioning

confidence: 99%

“…6 Near-infrared spectroscopy (NIRS) has been used largely in neonates for the noninvasive assessment of brain tissue oxygenation 7 and, less often, to evaluate limb oxygenation. [8][9][10][11][12] Considering that: (1) the spot measurement of BF and VO 2 by NIRS takes at least 20 minutes; and (2) the accuracy of NIRS changes is limited because path length and its changes are not known, 7 the foot PI measured by pulse oximetry seems to be more feasible than indirect NIRS methods for monitoring peripheral perfusion in the neonatal intensive care unit. We hypothesized that foot PI could also adequately evaluate limb perfusion.…”

Section: Introductionmentioning

confidence: 99%

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Foot Pulse Oximeter Perfusion Index Correlates with Calf Muscle Perfusion Measured by Near-Infrared Spectroscopy in Healthy Neonates

et al. 2005

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In critically ill neonates, peripheral perfusion and oxygenation assessment may provide indirect information on the circulatory failure of vital organs during circulatory shock. The development of pulse oximetry has recently made it possible to calculate the perfusion index (PI), obtained from the ratio between the pulsatile and nonpulsatile signals of absorbed light. The main goals of this study were: (1) to study foot PI; and (2) to evaluate the relationship between foot PI, obtained continuously by pulse oximetry, and a number of variables, i.e. blood flow (BF), oxygen delivery (DO 2 ), oxygen consumption (VO 2 ), and fractional oxygen extraction (FOE), measured indirectly by near-infrared spectroscopy (NIRS) on the calf in 43 healthy term neonates (weight 3474.6±466.9 g; gestational age 39.1±1.4 weeks). STUDY DESIGN:Calf BF, DO 2 and VO 2 were assessed by NIRS on short-lived venous and arterial occlusion maneuvers. PI was measured on the contralateral foot. RESULTS:Foot PI was 1.26±0.39. There was a positive correlation between foot PI and both calf BF (r ¼ 0.32, p ¼ 0.03) and DO 2 (r ¼ 0.32, p ¼ 0.03), but no correlation was found between foot PI and calf FOE and between foot PI and VO 2 . CONCLUSIONS:In the neonatal intensive care unit, continuously measuring foot PI by pulse oximetry seems clinically more feasible for peripheral perfusion monitoring than spot measurements of the calf BF and/or VO 2 by indirect NIRS.

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Section: Discussionmentioning

confidence: 99%

Section: Nirs and Venous Occlusion To Calculate Blood Flowmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Foot Pulse Oximeter Perfusion Index Correlates with Calf Muscle Perfusion Measured by Near-Infrared Spectroscopy in Healthy Neonates

et al. 2005

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“…Nevertheless, most studies on muscle oxygenation and hemodynamics were performed on healthy adults and adult patients [1,4,7] and on term and preterm neonates [8,9]. In a recent study we analyzed FBF in children and adolescents with type I diabetes and healthy children and adolescents [6].…”

Section: Near Infrared Spectroscopy (Nirs) Is a Relatively Newmentioning

confidence: 99%

Forearm Oxygen Consumption and Forearm Blood Flow in Healthy Children and Adolescents Measured by Near Infrared Spectroscopy

et al. 2006

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Abstract:The assessment of forearm oxygen consumption (VO 2 ) and forearm blood flow (FBF) by means of near infrared spectroscopy has become widespread in adults, whereas in children and adolescents no data are available. The aim of the present study was to analyze VO 2 and FBF in healthy children and adolescents. Methods: In a prospective cohort study, 20 male and 20 female healthy children and adolescents were investigated. The measurements of VO 2 and FBF were performed by means of near infrared spectroscopy in combination with the venous occlusion method. Results: Mean VO 2 was 0.08 ± 0.04 ml 100 g -1 min -1 in male and 0.09 ± 0.05 ml 100 g -1 min -1 in female subjects. Mean FBF was 1.95 ± 1.25 ml 100 g -1 min -1 in male and 1.82 ± 0.98 ml 100 g -1 min -1 in female subjects. No significant difference was found between male and female subjects. A significant negative correlation of VO 2 and FBF to age was observed in both groups. Conclusion: In the present study we were able to show that VO 2 and FBF decreased with increasing age in children and adolescents without significant differences between male and female subjects.Key words: near infrared spectroscopy, forearm oxygen consumption, forearm blood flow, development. Near infrared spectroscopy (NIRS) is a relatively newmethod, which is noninvasive and continuous and operates in real time, thus enabling in-vivo monitoring of tissue oxygenation and hemodynamics. NIRS has been applied to measure the oxygenation and hemodynamics of a variety of tissues, including muscle, brain, and connective tissue. With an adequate optode separation (more than 20 mm), the skin and the subcutaneous fat constitutes less than 5% of the signal measured over a given body segment in lean subjects [1,2]. The NIRS signal therefore predominately reflects the microcirculation and O 2 availability of tissue, which is dependent on interoptode distance, 2-6 cm deep [1]. Thus by positioning the optodes on the forearm, NIRS enables the measurement of the oxygenation and hemodynamics of forearm muscle.The venous occlusion, another noninvasive method, in combination with NIRS has been validated and has become an accepted method for the assessment of forearm muscular oxygen consumption (VO 2 ) [3][4][5] and forearm blood flow (FBF) [6]. Nevertheless, most studies on muscle oxygenation and hemodynamics were performed on healthy adults and adult patients [1,4,7] and on term and preterm neonates [8,9]. In a recent study we analyzed FBF in children and adolescents with type I diabetes and healthy children and adolescents [6].The aim of the present study was the measurement and analysis of VO 2 and FBF of forearm muscle in healthy children and adolescents. METHODSChildren and adolescents aged from 6 to 18 years were studied. The subjects, who were obese, i.e., body mass index (BMI) beyond the 90th percentile, or who had taken any medicaments within the past seven days, were excluded. Male and female subjects were matched for age (±6 months). Each subject was a volunteer, and informed consent was ob...

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“…Seit 1985 wird NIRS in zunehmendem Umfang in verschiedenen Bereichen der Humanmedizin erfolgreich als Monitoringmethode eingesetzt, um einen Abfall der zerebralen Oxygenierung z. B. bei frühgeborenen Kindern [42], bei Patienten mit massiven zerebralen Perfusionstö-rungen aufgrund neurologischer Erkrankungen [31] oder während operativer Eingriffe [29] frühzeitig zu erkennen.…”

Section: Historische Entwicklungunclassified

Nah-Infrarot-Spektroskopie in der Psychiatrie

et al. 2004

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Near-infrared spectroscopy (NIRS) is a noninvasive optical method for in vivo measurement of regional brain tissue oxygenation. Light from the near-infrared spectrum can penetrate the skull and is mainly absorbed by oxyhaemoglobin (O(2)Hb) and desoxyhaemoglobin (HHb). From the amount of reflected near-infrared light in relation to the amount absorbed by brain tissue, regional changes in O(2)Hb and HHb concentrations can be calculated spectrophotometrically. It has been shown that NIRS is not only able to measure massive disturbances in cerebral blood circulation due to serious neurological diseases, but that it also is sensitive enough to assess task-specific patterns of activation in healthy subjects during circumscribed cognitive processes. Preliminary investigations indicate altered regional brain tissue oxygenation in psychiatric patients during cognitive activation tasks. The NIRS outmatches other functional imaging methods in that it has no side effects and is well tolerated by psychiatric patients. Furthermore, it can be applied quickly and easily. Thus, NIRS is a potential screening method in psychiatric settings, provided that robust parameters of reliable diagnostic and/or prognostic value can be developed for individual psychiatric illnesses. However, this will depend on broader application of the method combined with established neurophysiological procedures and functional imaging techniques in psychiatric research.

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Peripheral Oxygenation in Preterm Infants

Cited by 13 publications

References 68 publications

Foot Pulse Oximeter Perfusion Index Correlates with Calf Muscle Perfusion Measured by Near-Infrared Spectroscopy in Healthy Neonates

Foot Pulse Oximeter Perfusion Index Correlates with Calf Muscle Perfusion Measured by Near-Infrared Spectroscopy in Healthy Neonates

Forearm Oxygen Consumption and Forearm Blood Flow in Healthy Children and Adolescents Measured by Near Infrared Spectroscopy

Nah-Infrarot-Spektroskopie in der Psychiatrie

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