Clinical use of cerebral oximetry in extremely preterm infants is feasible

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dc.contributor.authorHyttel-Sorensen, Simon
dc.contributor.authorAustin, Topun
dc.contributor.authorvan Bel, Frank
dc.contributor.authorBenders, Manon
dc.contributor.authorClaris, Olivier
dc.contributor.authorDempsey, Eugene M.
dc.contributor.authorFumagalli, Monica
dc.contributor.authorGluud, Christian
dc.contributor.authorHagmann, Cornelia
dc.contributor.authorHellström-Westas, Lena
dc.contributor.authorLemmers, Petra
dc.contributor.authorNaulaers, Gunnar
dc.contributor.authorvan Oeveren, Wim
dc.contributor.authorPellicer, Adelina
dc.contributor.authorPichler, Gerhard
dc.contributor.authorRoll, Claudia
dc.contributor.authorStoy, Lina Saem
dc.contributor.authorWolf, Martin
dc.contributor.authorGreisen, Gorm
dc.contributor.funderElsass Fondenen
dc.date.accessioned2017-09-01T15:00:39Z
dc.date.available2017-09-01T15:00:39Z
dc.date.issued2013-01
dc.date.updated2017-09-01T14:50:19Z
dc.description.abstractIntroduction: The research programme Safeguarding the Brains of our smallest Children (SafeBoosC) aims to test the benefits and harms of cerebral near-infrared spectroscopy (NIRS) oximetry in infants born before 28 weeks of gestation. In a phase II trial, infants will be randomised to visible cerebral NIRS oximetry with pre-specified treatment guidelines compared to standard care with blinded NIRS-monitoring. The primary outcome is duration multiplied with the extent outside the normal range of regional tissue oxygen saturation of haemoglobin (rStO2) of 55 to 85% in percentage hours (burden). This study was a pilot of the Visible ­Oximetry Group. Material and methods: This was an observational study including ten infants. Results: The median gestational age was 26 weeks + three days, and the median start-up time was 133 minutes after delivery. The median recording time was 69.7 hours, mean rStO2 was 64.2 ± 4.5%, median burden of hyper- and hy­poxia was 30.3% hours (range 2.8-112.3). Clinical staff responded to an out of range value 29 times – only once to values above 85%. In comparison, there were 83 periods of more than ten minutes with an rStO2 below 55% and four episodes with an rStO2 above 85%. These periods accounted for 72% of the total hypoxia burden. A total of 18 of the 29 interventions were adjustments of FiO2 which in 13 of the 18 times resulted in an out-of-range SpO2. Two infants suffered second-degree burns from the sensor. Five infants died. In all cases, this was unrelated to NIRS monitoring and treatment. Conclusion: The intervention of early cerebral NIRS monitoring proved feasible, but prolonged periods of hypoxia went untreated. Thus, a revision of the treatment guideline and an alarm system is required.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleidA4533
dc.identifier.citationHyttel-Sorensen, S. et al (2013) 'Clinical use of cerebral oximetry in extremely preterm infants is feasible', Danish Medical Journal, 60 (1): A4533 (5 pp.)en
dc.identifier.endpageA4533-5en
dc.identifier.issn2245-1919
dc.identifier.issued1en
dc.identifier.journaltitleDanish Medical Journalen
dc.identifier.startpageA4533-1en
dc.identifier.urihttps://hdl.handle.net/10468/4608
dc.identifier.volume60en
dc.language.isoenen
dc.publisherThe Danish Medical Association
dc.relation.urihttp://www.danmedj.dk/portal/page/portal/danmedj.dk/dmj_forside/PAST_ISSUE/2013/DMJ_2013_01/A4533
dc.rights© 2013, The Authors; Published by The Danish Medical Association, distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc/3.0/en
dc.subjectNear infrared spectroscopyen
dc.subjectOxygen saturationen
dc.subjectPremature Infantsen
dc.subjectHypoxiaen
dc.subjectSafeBoosCen
dc.subjectCerebral NIRS oximetryen
dc.titleClinical use of cerebral oximetry in extremely preterm infants is feasibleen
dc.typeArticle (peer-reviewed)en
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