Am J Perinatol 2021; 38(S 01): e299-e308
DOI: 10.1055/s-0040-1710033
Original Article

Near-Infrared Spectroscopy: A Tool for Diagnosing Necrotizing Enterocolitis at Onset of Symptoms in Preterm Neonates with Acute Gastrointestinal Symptoms?

Julia Le Bouhellec
1  Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Olivier Prodhomme
2  Department of Pediatric Radiology, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Thibault Mura
3  Department of Medical Information, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Aurélien Jacquot
1  Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Clémentine Combes
1  Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Lucie Gamon
3  Department of Medical Information, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Sabine Durand
1  Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
,
Anne Filleron
4  Department of Pediatrics, Carémeau Hospital, Nîmes University Hospital Center, Nîmes, France
,
1  Neonatal Intensive Care Unit, Arnaud de Villeneuve Hospital, Montpellier University Hospital Center, Montpellier, France
› Author Affiliations
Funding All phases of this study were supported by Montpellier University Hospital Center (Grant: research contract 2012–2015).

Abstract

Objective In premature neonates, bloody stools and/or abdominal distension with feeding intolerance may be inaugural signs of necrotizing enterocolitis (NEC). We assessed the ability of near-infrared spectroscopy (NIRS) to distinguish those neonates with NEC soon after the occurrence of these symptoms.

Study Design We prospectively collected NIRS measurements of abdominal and cerebral regional tissue oxygen saturation (r-SO2), with values masked by an opaque cover. Two physicians, blinded to the NIRS data, determined whether the gastrointestinal symptoms were related to NEC 10 days after symptom onset.

Results Forty-five neonates with mean (standard deviation [SD]) gestational, birth weight and postnatal ages of 31 (3.9) weeks, 1,486 (794) g, and 18 (14) days were enrolled over 30 months. Gastrointestinal symptoms were related to NEC in 23 patients and associated with other causes in 22. Analysis of the 48 hours of monitoring revealed comparable abdominal r-SO2 and splanchnic-cerebral oxygenation ratio (SCOR) in patients with and without NEC (r-SO2: 47.3 [20.4] vs. 50.4 [17.8], p = 0.59, SCOR: 0.64 [0.26] vs. 0.69 [0.24], p = 0.51). Results were unchanged after NIRS analysis in 6-hour periods, and restriction of the analysis to severe NEC (i.e., grade 2 and 3, 57% of the NEC cases).

Conclusion In this study, NIRS monitoring was unable to individualize NEC in premature infants with acute gastrointestinal symptoms.



Publication History

Received: 16 October 2019

Accepted: 19 March 2020

Publication Date:
23 April 2020 (online)

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