Daily Amplitude of Cerebral Regional Oxygen Saturationas a Criterion of Effectiveness of Intensive Care in Neonates with Respiratory Disorders
Purpose. To determine non-invasive criteria of intensive care efficiency in neonates with respiratory disorders. Materials and methods. The study included 78 newborns with gestational age of 37 [34; 39] weeks and clinical and laboratory markers of respiratory disorder. During the early neonatal period in addition to the standard monitoring of vital signs in all patients, we evaluated an abdominal and cerebral oxygenation using the INVOS 5100C cerebral/somatic oximeter (Covidien, Medtronic, USA). On the base of the time taken to reach cardiopulmonary stability (no need of any hemodynamic support and the presence of effective spontaneous breathing or switch to non-invasive mechanical ventilation), all patients were divided into three groups: 1st (25 patients) - 4 days of life, 2nd (31 patients) - 7 days of life, 3rd (22 patients) - more than 7 days.Results. Significant differences between the values at the beginning of intensive care and the time taken to reach cardiopulmonary stability were obtained only for daily amplitude of cerebral regional oxygen saturation - ΔcrSO2 (15 [9; 19] versus 6 [5; 9], p1-4=0.0049 in the first group and 12 [8; 19]versus 8 [5; 15], p1-7=0.0156 in the second one); ΔcrSO2 level in the groups was the following: 8 [5; 15]in the 1st group, 11 [8; 14] in the 2nd group, and the 3rd - 13 [9; 22], respectively, p<0.0001.Significant positive correlations (p<0.0001) were noted between the NIRS parameters and traditional clinical status markers.Conclusion. Daily amplitude of cerebral regional oxygen saturation could serve as a tool for assessment of intensive care (respiratory and hemodynamic) efficiency in neonates with respiratory disorders.