Early cerebral and intestinal oxygenation in the risk assessment of necrotizing enterocolitis in preterm infants.

Autor: Schat TE; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., van Zoonen AGJF; University of Groningen, University Medical Center Groningen, Department of Surgery, Division of Pediatric Surgery, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., van der Laan ME; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., Mebius MJ; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., Bos AF; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., Hulzebos CV; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., Boezen HM; University of Groningen, University Medical Center Groningen, Department of Epidemiology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., Hulscher JBF; University of Groningen, University Medical Center Groningen, Department of Surgery, Division of Pediatric Surgery, Hanzeplein 1, 9713 GZ Groningen, the Netherlands., Kooi EMW; University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Hanzeplein 1, 9713 GZ Groningen, the Netherlands. Electronic address: e.kooi@umcg.nl.
Jazyk: angličtina
Zdroj: Early human development [Early Hum Dev] 2019 Apr; Vol. 131, pp. 75-80. Date of Electronic Publication: 2019 Mar 11.
DOI: 10.1016/j.earlhumdev.2019.03.001
Abstrakt: Background and Aim: Predicting necrotizing enterocolitis (NEC) might help in preventing its devastating consequences. We aimed to investigate whether early cerebral and intestinal tissue oxygen saturation (rSO 2 ) and fractional tissue oxygen extraction (FTOE) predict the onset of NEC.
Study Design: Prospective observational case-control study.
Subjects: Infants with gestational age (GA) <32 weeks were included. For every NEC case we matched two controls based on GA, birth weight (BW), and a patent ductus arteriosus.
Outcome Measures: Cerebral oxygenation and intestinal oxygenation were prospectively monitored two-hours daily during the first five days after birth and once a week thereafter until five weeks after birth or until NEC developed. We used Kaplan-Meier analyses to determine the ability of near-infrared spectroscopy (NIRS) measurements, including their variability, to predict the development of NEC.
Results: We included ten infants (median (range) GA 27.1 (24.6-29.4) weeks, BW 903 (560-1630) grams) who developed NEC at median postnatal day 13 (range: 4-43 days), and 20 matched controls. Infants with cerebral rSO 2 <70% within the first 48 h after birth developed NEC significantly more often than infants with cerebral rSO 2 ≥70% (odds ratio 9.00 (95% CI 1.33-61.14). Intestinal FTOE was higher in infants who developed NEC compared to controls during the last NIRS measurement at median 2 days (range: 1-7) before NEC onset (median 0.65 vs. 0.44).
Conclusions: Cerebral oxygenation monitoring early after birth might be valuable in the risk assessment of NEC development. Additionally, our results suggest that intestinal oxygenation is impaired before the onset of clinical NEC.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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