Original scientific paper
Near infrared spectroscopy tissue oxygenation in infants with bronchiolitis during mechanical ventilation and spontaneous breathing
STEFAN GROSEK
; Department of Pediatric Surgery and Intensive Therapy, University Medical Centre Ljubljana, Surgical Service, Medical Faculty, University of Ljubljana, Bohoriceva 20. 1000 Ljubljana. Slovenia
MARTA ZNIDARSIC ERZEN
; Pediatric Clinical Department, Community Health Centre Ljubljana, Metelkova ulica 9. , 1000 Ljubljana, Slovenia
MARTINA JELIC
; General Hospital Celje, Oblakova 30., 3000 Celje, Slovenia
ANA GORNIK
; Hospital Sežana, Cankarjeva ulica 4., 6210 Sežana, Slovenia
MATEJ PODBREGAR
; Department of Intensive Care Medicine, University Medical Centre Ljubljana, Zaloska c 7., 1000 Ljubljana, Slovenia
Abstract
Introduction. Near-infrared spectroscopy (NIRS) was used in infants with acute bronchiolitis as a noninvasive indicator of
tissue oxygenation to determine regional tissue oxygen saturation (rStO2) and fractional tissue oxygen extraction (FTOE)
during mechanical ventilation and spontaneous breathing.
Methods. Twenty-seven infants with bronchiolitis that needed mechanical ventilation were included in a prospective study.
Regional StO2 in brain, liver, kidney and skeletal muscle tissue was measured on admission to the Intensive Care Unit (ICU),
on day 1 (D1); after two to three days of mechanical ventilation (D2); on the last day of mechanical ventilation (D3) and
during spontaneous breathing (D4). Measurements were conducted by in-vivo optical spectroscopy. For research purposes
we divided the infants according to C-reactive protein (CRP) levels, with a cut-off value of 10 mg/ml on admission, into low
(l-CRP) and high (h-CRP) groups.
Results. During mechanical and spontaneous breathing we found lower StO2 and higher FTOE for skeletal muscle at D4
compared to D1-D2 in the h-CRP group of patients. Differences between l- and h-CRP groups in rStO2 were found for brain
tissue on D3, D4, and in rStO2 and FTOE for liver tissue on D3. A strong negative correlation was found between rStO2
and FTOE in all tissues. A positive correlation was found between CRP and rStO2 and negative between CRP and FTOE in
skeletal muscle among all patients combined.
Conclusion. Only Infants with acute bronchiolitis in the h-CRP group have significant changes in rStO2 and FTOE in skeletal
muscles during mechanical ventilation and spontaneous breathing. Regional StO2 and FTOE in all the other measured
tissues never decreased below normal values.
Keywords
bronchiolitis; near-infrared spectroscopy; fractional tissue oxygen extraction (FTOE); regional oxygen saturation (rStO2)
Hrčak ID:
134211
URI
Publication date:
1.10.2014.
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