The Relation Between Oxygen Saturation Measured by Pulse Oximetry vs Near-infrared Spectroscopy Following Surfactant Therapy in Very Low-birth-weight Neonates

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2023-12-07 DOI:10.5812/ijp-140078

Maryam Veisizadeh, Seyed Abolfazl Afjehi, M. Zarkesh, Mohammad Kazemian, Ahmad Shafaeizadeh, Leila Khedmat

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引用次数: 0

Abstract

Background: Monitoring regional cerebral oxygen saturation (rScO2) and hemodynamic stability (eg, mean arterial blood pressure [MABP]) in high-risk premature infants is crucial to enhance daily clinical practices in neonatal intensive care units (NICUs). Objectives: This study aimed to investigate potential differences between oxygen saturation measurements obtained via near-infrared spectroscopy (NIRS) and pulse oximetry (PO). Methods: This pilot study enrolled 20 very low-birth-weight (VLBW) premature neonates through a non-random, available sampling approach. We gathered maternal and fetal demographic data along with clinical characteristics of the neonates. The study focused on assessing tissue and cerebral oxygenation using PO and NIRS. We specifically monitored changes in mean rScO2 and MABP at various time points: before, during, and 5 and 10 min after the administration of surfactant injection (SI) via the endotracheal tube. Results: The mean gestational age, neonatal birth weight, and Apgar scores at 1 and 5 min after birth were 28.44 ± 2.57 weeks, 1063 ± 246 g, 6.05 ± 2.57, and 7.94 ± 1.79, respectively. No significant differences were observed between mean rScO2 values measured by NIRS and PO before (P = 0.631), during (P = 0.722), and 5 min after (P = 0.783) SI. However, a significant difference between PO and NIRS-based rScO2 values was found 10 min after SI (96.95% vs 75.0%; P = 0.04). Additionally, there was no significant correlation between mean rScO2 and MABP recorded before, during, and after SI. Conclusions: There were no differences in oxygen saturation measurements (recorded by PO) and rScO2 values (recorded by NIRS) before, during, and immediately after SI. Therefore, using PO in NICUs to assess cerebral oxygenation, autoregulation, and hypoxia appears both reasonable and cost-effective. Further multicenter studies are needed to validate the practical advantages and cost-effectiveness of NIRS as an emerging monitoring system.

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极低出生体重新生儿接受表面活性剂治疗后用脉搏氧饱和度仪测量的氧饱和度与用近红外光谱仪测量的氧饱和度之间的关系

背景:监测高危早产儿区域脑氧饱和度(rScO2)和血流动力学稳定性(如平均动脉血压[MABP])对于加强新生儿重症监护病房(NICUs)的日常临床实践至关重要。目的:本研究旨在探讨近红外光谱(NIRS)和脉搏血氧仪(PO)测量的氧饱和度之间的潜在差异。方法:本研究采用非随机、有效的抽样方法，招募了20例极低出生体重早产儿。我们收集了产妇和胎儿的人口统计数据以及新生儿的临床特征。研究的重点是利用PO和NIRS评估组织和脑氧合。我们专门监测了不同时间点的平均rScO2和MABP的变化:在气管内注射表面活性剂(SI)之前、期间、5分钟和10分钟后。结果:出生后1 min、5 min平均胎龄28.44±2.57周，新生儿体重1063±246 g, Apgar评分6.05±2.57,7.94±1.79。NIRS测量的rScO2平均值与PO在SI前(P = 0.631)、SI中(P = 0.722)和SI后5 min (P = 0.783)无显著差异。然而，在SI后10分钟，PO和nir的rScO2值存在显著差异(96.95% vs 75.0%;P = 0.04)。此外，在SI之前，期间和之后记录的平均rScO2和MABP之间没有显着相关性。结论:在SI之前，SI期间和SI之后，氧饱和度测量(通过PO记录)和rScO2值(通过NIRS记录)没有差异。因此，在nicu中使用PO来评估脑氧合、自动调节和缺氧是合理和划算的。需要进一步的多中心研究来验证近红外光谱作为一种新兴监测系统的实际优势和成本效益。

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.