Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Wolfsberger, C.
Peripheral fractional tissue oxygen extraction and infection in term and preterm neonates: a prospective pilot observational study
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Medizinische Universität Graz; 2024. pp. 96
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- Autor*innen der Med Uni Graz:
- Wolfsberger Christina Helene
- Betreuer*innen:
- Pichler Gerhard
- Reif Philipp
- Urlesberger Berndt
- Altmetrics:
- Abstract:
- Introduction Peripheral muscle oxygenation enables early recognition of microcircular dysfunction in cases of infection/inflammation and/or sepsis. Peripheral fractional tissue oxygen extraction (pFTOE) represents the relative extraction from arterial to venous compartment, which provides information about oxygen consumption and oxygen delivery to tissue. Primary aim of the present study was to investigate, whether pFTOE measured within the first six hours after birth differs in term and preterm neonates, with laboratory signs of infection and without infection. Methods This study was performed as a prospective observational study performed at the Division of Neonatology Graz. Term and preterm neonates ≥30 weeks of gestational age with respiratory distress, admission to the NICU and age < 6 hours were included in the present study. Within the first six hours after birth, peripheral and cerebral NIRS measurements, performed by five short (re-)applications on the right forearm and on the left forehead, respectively, were conducted. Routine monitoring of arterial oxygen saturation (SpO2), heart rate (HR), mean arterial blood pressure (MABP) were documented in the time frame of NIRS measurements. pFTOE was calculated by the formula using peripheral tissue oxygenation index (pTOI) and SpO2: pFTOE = (SpO2-pTOI)/SpO2. Routine blood samples, including C- reactive protein, leukocytes and IT-ratio during the first 48 hours after birth were collected. Neonates with signs of infection, defined as CRP >10mg/l, leukocytes <6000/µl or >30000/µl, IT ratio >0.2 and/or positive blood culture were stratified to the infection group. Those neonates with inauspicious laboratory parameter were stratified to the no-infection group. Neonates of the infection group were compared to the no-infection group. Term and preterm neonates were analysed separately. Results A total of 80 neonates, 32 term neonates (infection n=15, no-infection group n=17) and 48 preterm neonates (n=6, n=42), were included in the present study. Gestational age and birth weight were 39.6 ±1.7 weeks and 3543 ±615 grams and 38.5 ±1.4 and 3221 ±592 grams in term neonates of the infection group and of the no-infection group, respectively. There were no differences in pFTOE 0.229 ±0.064 in the infection group and 0.235 ±0.032 in the no-infection group (p=0.293). In preterm neonates, gestational age and birth weight were 34.8 ±1.7 weeks and 2476 ±720 grams and 34.3 ±1.6 and 2284 ±474 grams in the infection group and in the no-infection group, respectively. There were no differences in pFTOE 0.235 ±0.050 in the infection group and 0.224 ±0.051 in the no-infection group (p=0.306). Conclusion In the present study, in term and preterm neonates with infection no difference in pFTOE measured by five short reapplications within the first six hours were observed compared to neonates without infection. Nevertheless, pFTOE as an early marker for microcirculatory dysfunction is still of interest in neonates with respiratory distress symptoms within the first hours after birth.