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Original Research

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Near infrared spectroscopy tissue oxygenation in infants with bronchiolitis during mechanical ventilation and spontaneous breathing

  • MARTA ZNIDARSIC ERZEN1
  • MARTINA JELIC2
  • ANA GORNIK3
  • MATEJ PODBREGAR4
  • STEFAN GROSEK5

1,Pediatric Clinical Department Community Health Centre Ljubljana

2,General Hospital Celje

3,Hospital Sežana

4,Department of Intensive Care Medicine University Medical Centre Ljubljana

5Department of Pediatric Surgery and Intensive Therapy University Medical Centre Ljubljana Surgical Service Medical Faculty, University of Ljubljana

DOI: 10.22514/SV92.112014.3 Vol.9,Issue 2,November 2014 pp.15-24

Published: 03 November 2014

*Corresponding Author(s): STEFAN GROSEK E-mail: stefan.grosek@mf.uni-lj.si

Abstract

Introduction. Near-infrared spectroscopy (NIRS) was used in infants with acute bronchiolitis as a noninvasive indicator of 

tissue oxygenation to determine regional tissue oxygen saturation (rStO2) and fractional tissue oxygen extraction (FTOE) during mechanical ventilation and spontaneous breathing. 

Methods. Twenty-seven infants with bronchiolitis that needed mechanical ventilation were included in a prospective study. 

Regional StO2 in brain, liver, kidney and skeletal muscle tissue was measured on admission to the Intensive Care Unit (ICU), on day 1 (D1); after two to three days of mechanical ventilation (D2); on the last day of mechanical ventilation (D3) and during spontaneous breathing (D4). Measurements were conducted by in-vivo optical spectroscopy. For research purposes we divided the infants according to C-reactive protein (CRP) levels, with a cut-off value of 10 mg/ml on admission, into low (l-CRP) and high (h-CRP) groups.

Results. During mechanical and spontaneous breathing we found lower StO2 and higher FTOE for skeletal muscle at D4 compared to D1-D2 in the h-CRP group of patients. Differences between l- and h-CRP groups in rStO2 were found for brain tissue on D3, D4, and in rStO2 and FTOE for liver tissue on D3. A strong negative correlation was found between rStO2 and FTOE in all tissues. A positive correlation was found between CRP and rStO2 and negative between CRP and FTOE in skeletal muscle among all patients combined. 

Conclusion. Only Infants with acute bronchiolitis in the h-CRP group have significant changes in rStO2 and FTOE in skele-tal muscles during mechanical ventilation and spontaneous breathing. Regional StO2 and FTOE in all the other measured tissues never decreased below normal values. 

Keywords

bronchiolitis, near-infra-red spectroscopy, fractional tissue oxygen extraction (FTOE), regional 

oxygen saturation (rStO2)

Cite and Share

MARTA ZNIDARSIC ERZEN,MARTINA JELIC,ANA GORNIK,MATEJ PODBREGAR,STEFAN GROSEK. Near infrared spectroscopy tissue oxygenation in infants with bronchiolitis during mechanical ventilation and spontaneous breathing. Signa Vitae. 2014. 9(2);15-24.

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