van der Heide Martin, Dotinga Baukje M, Stewart Roy E, Kalteren Willemien S, Hulscher Jan B F, Reijneveld Sijmen A, Bos Arend F, Kooi Elisabeth M W
Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Pediatr Res. 2021 Oct;90(4):882-887. doi: 10.1038/s41390-020-01323-3. Epub 2021 Jan 27.
Near-infrared spectroscopy is used in the assessment of regional splanchnic oxygen saturation (rSO), but solid reference values are scarce. We aimed to establish reference values of rSO for preterm infants during the first week after birth, both crude and modeled based on predictors.
We included infants with gestational age (GA) <32 weeks and/or birth weight <1200 g. We excluded infants who developed necrotizing enterocolitis or sepsis or who died. In the first week after birth, we determined a daily 2-h mean of rSO to assess its associations with sex, GA, postnatal age (PNA), small-for-gestational age (SGA) status, patent ductus arteriosus, hemoglobin, nutrition, and head circumference at birth and translated those into a prediction model.
We included 220 infants. On day 1, the mean ± SD rSO value was 48.2% ± 16.6. The nadir of rSO was on day 4 (38.7% ± 16.6 smoothed line) to 5 (37.4%±17.3, actual data), after which rSO increased to 44.2% ± 16.6 on day 7. The final model of the reference values of rSO included the following coefficients: rSO = 3.2 - 7.0 × PNA + 0.8 × PNA - 4.0 × SGA + 1.8 × GA.
We established reference values of rSO for preterm infants during the first week after birth. GA, PNA, and SGA affect these values and need to be taken into account.
Regional splanchnic oxygen saturation is lower in infants with a lower gestational age and in small-for-gestational age infants. Regional splanchnic oxygen saturation decreases with a higher postnatal age until day 4 after birth and then increases until day 7 after birth. Gestational age, postnatal age, and small-for-gestational age status affect regional splanchnic oxygen saturation and need to be taken into account when interpreting regional splanchnic oxygen saturations using NIRS. Reference values for infant regional splanchnic oxygen saturation can be computed with a formula based on these variables, as provided by this study.
近红外光谱法用于评估局部内脏氧饱和度（rSO），但可靠的参考值较少。我们旨在确定早产儿出生后第一周的rSO参考值，包括原始值以及基于预测因素的模型值。
我们纳入了胎龄（GA）<32周和/或出生体重<1200克的婴儿。我们排除了发生坏死性小肠结肠炎或败血症或死亡的婴儿。在出生后的第一周，我们确定了每日2小时的rSO平均值，以评估其与性别、GA、出生后年龄（PNA）、小于胎龄儿（SGA）状态、动脉导管未闭、血红蛋白、营养状况以及出生时头围的相关性，并将这些因素转化为一个预测模型。
我们纳入了220名婴儿。在第1天，rSO的平均值±标准差为48.2%±16.6。rSO的最低点出现在第4天（平滑线为38.7%±16.6）至第5天（实际数据为37.4%±17.3），之后在第7天rSO升至44.2%±16.6。rSO参考值的最终模型包括以下系数：rSO = 3.2 - 7.0×PNA + 0.8×PNA - 4.0×SGA + 1.8×GA。
我们确定了早产儿出生后第一周的rSO参考值。GA、PNA和SGA会影响这些值，需要予以考虑。
胎龄较小的婴儿和小于胎龄儿的局部内脏氧饱和度较低。局部内脏氧饱和度在出生后年龄较大时会降低，直到出生后第4天，然后在出生后第7天之前升高。胎龄、出生后年龄和小于胎龄儿状态会影响局部内脏氧饱和度，在使用近红外光谱法解释局部内脏氧饱和度时需要予以考虑。本研究提供了一个基于这些变量的公式，可用于计算婴儿局部内脏氧饱和度的参考值。
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