Abstract
Background
Abdominal near-infrared spectroscopy (aNIRS) may detect gastrointestinal hypoxia before necrotizing enterocolitis develops. We sought to validate aNIRS during splanchnic hypoxia and hypoperfusion in neonatal piglets.
Methods
Anesthetized piglets underwent systemic hypoxia or 3 h superior mesenteric artery (SMA) ligation with aNIRS monitoring.
Results
During progressive hypoxia, gastrointestinal tissue oxyhemoglobin saturation measured by aNIRS decreased linearly with oxyhemoglobin saturation measured directly in the portal vein. Correlation coefficients were 0.94–0.99 in each of 10 piglets, the average regression slope of 0.73 (95% confidence interval: 0.57, 0.89) differed from one (P<0.004), and the intercept on the aNIRS axis of 9.5% (4.4, 14.6) differed from zero (P<0.0025). Umbilical venous oxyhemoglobin saturation also correlated strongly with the portal vein oxyhemoglobin saturation (r=0.83–0.99), with a slope not different from one. SMA ligation caused ileal blood flow to decrease by ~50%, and produced a sustained decrease in aNIRS oximetry from approximately 60 to 30%.
Conclusion
aNIRS can detect abrupt and sustained gastrointestinal hypoperfusion associated with arterial occlusion in a neonatal model. The highly linear relationship of portal venous oxyhemoglobin saturation with aNIRS and umbilical vein saturation during graded hypoxia implies that these measures can accurately track tissue oxygenation trends over a wide range in individual subjects.
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J.K.L. was a paid advisory board member for Medtronic. J.K.L. also received a research grant from Medtronic for a separate clinical study on cerebrovascular autoregulation. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. Medtronic did not provide any support (financial or other) or have any input on the study design, data acquisition, or data interpretation for the current piglet study on gastrointestinal hypoxia and hypoperfusion. The remaining authors declare no conflict of interest.
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STATEMENT OF FINANCIAL SUPPORT
Support was provided by NIH grants K08NS080984 (J.K.L.) and R01NS060703 (R.C.K.) and an American Heart Association Grant-in-Aid (J.K.L.). D.J.H. is supported by R01GM078238 and R01DK083752.
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Chen, M., Reyes, M., Kulikowicz, E. et al. Abdominal near-infrared spectroscopy in a piglet model of gastrointestinal hypoxia produced by graded hypoxia or superior mesenteric artery ligation. Pediatr Res 83, 1172–1181 (2018). https://doi.org/10.1038/pr.2018.37
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DOI: https://doi.org/10.1038/pr.2018.37
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