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Monitoring abdominal near-infrared spectroscopy during feeds in neonates with CHD recovering from surgery: a feasibility study

Published online by Cambridge University Press:  18 November 2024

Evan M. Holleran ,
Marshall D. Brown ,
Claudia Sassano ,
Ndidiamaka Musa ,
Jessica Colyer  and
Eyal Sagiv Open the ORCID record for Eyal Sagiv [Opens in a new window]
Evan M. Holleran
Affiliation:
Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, WA, USA
Marshall D. Brown
Affiliation:
Department of Biostatistics, Seattle Children’s Research Institute, University of Washington School of Medicine, Seattle, WA, USA
Claudia Sassano
Affiliation:
Division of Cardiac Critical Care, Seattle Children’s Hospital, Seattle, WA, USA Department of Nutrition, Seattle Children’s Hospital, Seattle, WA, USA
Ndidiamaka Musa
Affiliation:
Division of Cardiac Critical Care, Seattle Children’s Hospital, Seattle, WA, USA
Jessica Colyer
Affiliation:
Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, WA, USA
Eyal Sagiv*
Affiliation:
Division of Pediatric Cardiology, Seattle Children’s Hospital, Seattle, WA, USA
*
Corresponding author: Eyal Sagiv; Email: [email protected]
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Abstract

Objective:

Monitoring cerebral and renal near-infrared spectroscopy for regional venous oxygenation is a common practice in the postoperative care of neonates recovering from surgery for CHD. In this study, we aimed to test the feasibility of using this technology for monitoring changes in splanchnic perfusion during feeds in infants recovering from cardiac surgery.

Methods:

We monitored renal and splanchnic near-infrared spectroscopy in 29 neonates once recovered from the critical postoperative state and tolerating full enteral nutrition. Infants were tested over 3 feeds for splanchnic regional oxygenation (rO2), arterial to splanchnic saturation difference and splanchnic to renal regional oxygenation ratio.

Result:

Splanchnic regional oxygenation data were obtained with no failure or interruptions. Interclass correlation for agreement between measurements suggested good repeatability: 0.84 at baseline and 0.82 at end of feed. Infants with physiologic repair (n = 19) showed a trend towards increased splanchnic regional oxygenation at the end of feeds and were more likely to achieve regional oxygenation > 50% compared to infants with shunt-dependent circulation (n = 10, p = 0.02). Calculating AVO2 and regional oxygenation index did not result in improved test sensitivity.

Conclusion:

Monitoring splanchnic regional oxygenation during feeds for infants recovering from congenital heart surgery is feasible and reliable. These results suggest that near-infrared spectroscopy could be further studied as a tool for bedside monitoring to assist in feeding management and prevention of necrotising enterocolitis in this sensitive patient population.

Keywords

Near-infrared spectroscopycHDneonatal outcomesnecrotising enterocolitis
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 11 , November 2024 , pp. 2355 - 2361
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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