The Effect of Continuous Positive Airway Pressure on Cerebral and Splanchnic Oxygenation in Preterm Infants.
Cerebral oxygenation
Continuous positive airway pressure
Near-infrared spectroscopy
Preterm infants
Splanchnic oxygenation
Journal
Neonatology
ISSN: 1661-7819
Titre abrégé: Neonatology
Pays: Switzerland
ID NLM: 101286577
Informations de publication
Date de publication:
2019
2019
Historique:
received:
06
04
2019
accepted:
04
07
2019
pubmed:
20
9
2019
medline:
19
6
2020
entrez:
20
9
2019
Statut:
ppublish
Résumé
Despite the known clinical benefits of continuous positive airway pressure (CPAP) to support preterm infants breathing, there are limited studies that have examined its effect on regional oxygenation. This study aimed to investigate how the application of CPAP affects cerebral and splanchnic tissue oxygenation in preterm infants. A pilot observational study was conducted in infants using near-infrared spectroscopy while off CPAP and on CPAP. Regional cerebral and splanchnic saturations and variability (coefficient of variability; CV) were evaluated. Twenty-six infants (25-37 weeks gestational age at birth) were studied. The mean cerebral oxygenation did not differ with the application of CPAP (80 ± 4.2% without CPAP; 80 ± 1.9% with CPAP), but variability around the mean was less with CPAP (CV 5 vs. 2%, respectively). Mean cerebral fractional oxygen extraction (FOE) increased with CPAP from 0.13 ± 0.06 to 0.17 ± 0.04% (p = 0.002). Splanchnic oxygenation increased significantly from 66 ± 11.6 to 75 ± 9.1% with CPAP (p < 0.001) and also became more stable (CV 13 vs. 7%, respectively). Splanchnic FOE decreased with CPAP from 0.28 ± 0.13 to 0.22 ± 0.10% (p = 0.002). The application of CPAP did not affect mean cerebral oxygenation in this group of preterm and term infants; however, it led to a significant increase in splanchnic oxygenation. These findings highlight the important role that respiratory support may play in maintaining adequate and stable oxygen delivery to vital organs.
Sections du résumé
BACKGROUND
Despite the known clinical benefits of continuous positive airway pressure (CPAP) to support preterm infants breathing, there are limited studies that have examined its effect on regional oxygenation.
OBJECTIVES
This study aimed to investigate how the application of CPAP affects cerebral and splanchnic tissue oxygenation in preterm infants.
METHODS
A pilot observational study was conducted in infants using near-infrared spectroscopy while off CPAP and on CPAP. Regional cerebral and splanchnic saturations and variability (coefficient of variability; CV) were evaluated.
RESULTS
Twenty-six infants (25-37 weeks gestational age at birth) were studied. The mean cerebral oxygenation did not differ with the application of CPAP (80 ± 4.2% without CPAP; 80 ± 1.9% with CPAP), but variability around the mean was less with CPAP (CV 5 vs. 2%, respectively). Mean cerebral fractional oxygen extraction (FOE) increased with CPAP from 0.13 ± 0.06 to 0.17 ± 0.04% (p = 0.002). Splanchnic oxygenation increased significantly from 66 ± 11.6 to 75 ± 9.1% with CPAP (p < 0.001) and also became more stable (CV 13 vs. 7%, respectively). Splanchnic FOE decreased with CPAP from 0.28 ± 0.13 to 0.22 ± 0.10% (p = 0.002).
CONCLUSION
The application of CPAP did not affect mean cerebral oxygenation in this group of preterm and term infants; however, it led to a significant increase in splanchnic oxygenation. These findings highlight the important role that respiratory support may play in maintaining adequate and stable oxygen delivery to vital organs.
Identifiants
pubmed: 31536981
pii: 000501936
doi: 10.1159/000501936
doi:
Substances chimiques
Oxygen
S88TT14065
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
363-368Informations de copyright
© 2019 S. Karger AG, Basel.