Early brain and abdominal oxygenation in extremely low birth weight infants

Background Extremely low birth weight (ELBW) infants are at risk for end-organ hypoxia and ischemia. Regional tissue oxygenation of the brain and gut as monitored with near-infrared spectroscopy (NIRS) may change with postnatal age, but normal ranges are not well defined. Methods A prospective study...

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Published in:Pediatric research 2022-10, Vol.92 (4), p.1034-1041
Main Authors: Chock, Valerie Y., Smith, Emily, Tan, Sylvia, Ball, M. Bethany, Das, Abhik, Hintz, Susan R., Kirpalani, Haresh, Bell, Edward F., Chalak, Lina F., Carlo, Waldemar A., Cotten, C. Michael, Widness, John A., Kennedy, Kathleen A., Ohls, Robin K., Seabrook, Ruth B., Patel, Ravi M., Laptook, Abbot R., Mancini, Toni, Sokol, Gregory M., Walsh, Michele C., Yoder, Bradley A., Poindexter, Brenda B., Chawla, Sanjay, D’Angio, Carl T., Higgins, Rosemary D., Van Meurs, Krisa P.
Format: Article
Language:English
Subjects:
Apgar score
Birth Weight
Brain
Cerebrovascular Circulation
Clinical Research Article
Female
Gestational age
Hemoglobin
Hemoglobins
Humans
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature
Medicine
Medicine & Public Health
Newborn babies
Oxygen
Pediatric Surgery
Pediatrics
Pregnancy
Premature babies
Prospective Studies
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Summary:Background Extremely low birth weight (ELBW) infants are at risk for end-organ hypoxia and ischemia. Regional tissue oxygenation of the brain and gut as monitored with near-infrared spectroscopy (NIRS) may change with postnatal age, but normal ranges are not well defined. Methods A prospective study of ELBW preterm infants utilized NIRS monitoring to assess changes in cerebral and mesenteric saturation (Csat and Msat) over the first week after birth. This secondary study of a multicenter trial comparing hemoglobin transfusion thresholds assessed cerebral and mesenteric fractional tissue oxygen extraction (cFTOE and mFTOE) and relationships with perinatal variables. Results In 124 infants, both Csat and Msat declined over the first week, with a corresponding increase in oxygen extraction. With lower gestational age, lower birth weight, and 5-min Apgar score ≤5, there was a greater increase in oxygen extraction in the brain compared to the gut. Infants managed with a lower hemoglobin transfusion threshold receiving ≥2 transfusions in the first week had the lowest Csat and highest cFTOE ( p  
ISSN:0031-3998
1530-0447
DOI:10.1038/s41390-022-02082-z