Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Oslo University Hospital Rikshospitalet, University of Oslo, Oslo, Norway.
Pediatr Res. 2022 Aug;92(2):445-452. doi: 10.1038/s41390-021-01819-6. Epub 2021 Nov 1.
Increasing evidence recognizes the harm of excess oxygen to lungs, eyes, and brain of preterm infants, but not yet to the intestine. We assessed changes in splanchnic oxygenation during reoxygenation with 21% compared to 100% O in a newborn piglet model of perinatal asphyxia.
We randomized 25 piglets to control or intervention. Intervention groups underwent global hypoxia until acidosis and hypotension occurred. Piglets were reoxygenated for 30 min with 21% or 100% O and observed for 9 h. We continuously measured regional splanchnic oxygen saturation (rSO) using near-infrared spectroscopy (NIRS). We calculated mean rSO and rCoVar (as SD/mean). We measured PaO and SaO, sampled from the right carotid artery.
Reoxygenation after global hypoxia restored rSO. Reoxygenation with 100% O increased rSO to values significantly higher than baseline. In intervention groups, rCoVar decreased during observation compared to baseline. We found a correlation between rSO and PaO (r = 0.420, P < 0.001) and between rSO and SaO (r = 0.648, P < 0.001) in pooled data from the entire experiment.
Reoxygenation after global hypoxia improves splanchnic oxygenation, but is associated with reduced variability of rSO. Reoxygenation with 100% O exposes the intestine to hyperoxia. Splanchnic NIRS is able to detect intestinal hypoxia and hyperoxia.
Splanchnic oxygenation improves during reoxygenation after global hypoxia, though reoxygenation with 100% O exposes the intestine to hyperoxia. Decreased variability of splanchnic oxygenation several hours after hypoxia and reoxygenation seems to be independent of the resuscitation strategy, and may indicate intestinal injury. Splanchnic NIRS monitoring was able to detect intestinal hypoxia and exposure to hyperoxia, as evidenced by a strong correlation between splanchnic oxygenation and arterial oxygen content.
越来越多的证据表明，早产儿的肺部、眼睛和大脑会受到过量氧气的伤害，但肠道尚未受到影响。我们评估了围产期窒息新生仔猪模型中，与 100%氧气相比，21%氧气再给氧时内脏氧合的变化。
我们将 25 只仔猪随机分为对照组和干预组。干预组经历全身缺氧，直至发生酸中毒和低血压。仔猪接受 21%或 100%氧气再给氧 30 分钟，并观察 9 小时。我们使用近红外光谱（NIRS）连续测量局部内脏氧饱和度（rSO）。我们计算平均 rSO 和 rCoVar（作为 SD/mean）。我们从右颈总动脉抽取血样测量 PaO 和 SaO。
全身缺氧后的再给氧恢复了 rSO。100%氧气再给氧使 rSO 增加到明显高于基线的水平。在干预组中，与基线相比，观察期间 rCoVar 降低。我们在整个实验的汇总数据中发现 rSO 与 PaO（r=0.420，P<0.001）和 rSO 与 SaO（r=0.648，P<0.001）之间存在相关性。
全身缺氧后的再给氧可改善内脏氧合，但与 rSO 变异性降低有关。100%氧气再给氧使肠道暴露于高氧环境中。内脏 NIRS 能够检测到肠道缺氧和高氧。
全身缺氧后的再给氧可改善内脏氧合，但 100%氧气再给氧使肠道暴露于高氧环境中。缺氧和再给氧数小时后，内脏氧合的变异性降低似乎与复苏策略无关，可能提示肠道损伤。内脏 NIRS 监测能够检测到肠道缺氧和高氧暴露，因为内脏氧合与动脉血氧含量之间存在很强的相关性。
