G198(P) Gut and cerebral oxygenation in preterm infants over the first 8 weeks of life: what is normal?. (May 2019)

• Record Type: Journal Article
• Authors: Howarth, C; Banerjee, J; Leung, T; Eaton, S; Morris, J; Aladangady, N
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A80
• Page End: A80
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.193
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aims: To establish currently lacking norms of gut and cerebral oxygenation for preterm infants born at <30 weeks gestation. Methods: Weekly cerebral and splanchnic Near Infrared Spectroscopy (NIRS) measurements were recorded in 48 infants<30 w gestation using NIRO-300 (Hamamatsu KK, Japan). Infants with a birthweight ≤2 nd centile, abnormal antenatal dopplers, major congenital anomalies or twin to twin transfusion syndrome were excluded. NIRS probes were placed on the abdomen and forehead weekly for 60 min to simultaneously measure gut (g) and cerebral (c) Tissue Oxygenation Index (TOI), from week 1 of life until 36 weeks corrected gestational age or discharge. Subsequently Fractional Tissue Oxygen Extraction (FTOE) and Splanchnic Cerebral Oxygenation Ratio (SCOR) were calculated. Results: Median birthweight was 884 g (460–1600 g), median gestational age was 26 +3 weeks (23 +0– 29 +6 ) and 52% female. Data was excluded from five infants who developed Haemorrhagic Parenchymal Infarcts (HPI) and seven with Necrotising Enterocolitis (NEC). Weekly mean cTOI, sTOI, SCOR, cFTOE and sFTOE are presented in table 1 . Across all 8 weeks of life cTOI was greater than sTOI (p<0.0001). SCOR was <0.75 for most weeks and lowest in week 2. Conclusion: This is the first report of normative data on splanchnic oxygenation over the first 8 weeks of life in preterm infants<30 weeks gestation. Across all 8 weeks cerebral oxygenation was higher than splanchnic. A high FTOE represents impaired tissue perfusion and a lower SCOR confers a higher risk of intestinal ischaemia and gut injury. From our results the first 2 weeks of life appear to be the critical period for developing gut injury.