Abstract
Background Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue oxygenation and perfusion. The aim of this study was to evaluate cerebral and splanchnic NIRS changes in CDH operated infants enrolled into the VICI trial and therefore randomized for ventilatory modalities. Materials and methods CDH newborns enrolled into the VICI trial (Netherlands Trial Register, NTR 1310) were randomized at birth for high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) according to the trial. Cerebral oxygenation (rSO2C) and splanchnic oxygenation (rSO2S) were obtained by NIRS (INVOS 5100; Somanetics, Troy, MI) before and after surgery. Variations in rSO2C and rSO2S were evaluated. Mann-Whitney test and one-way ANOVA were used as appropriate. p <0.05 was considered significant. Results Thirteen VICI trial patients underwent surgical repair between March 2011 and December 2012, and were enrolled in the study. Seven patients were assigned to HFOV and six to CMV group respectively. During surgery, a significant reduction in rSO2C (p = 0.0001) and rSO2S (p = 0.005) were observed. HFOV patients experienced prolonged reduction in rSO2C value (p = 0.003) while rSO2S did not vary between HFOV and CMV (p = 0.94). Conclusions Surgical CDH repair was associated with decrease of cerebral and splanchnic oxygenation, regardless of ventilation. Patients ventilated by HFOV need a longer time interval to recovery normal rSO2C values, than those ventilated by CMV. This may be owing to a different impact of HFOV on patients' hemodynamic status with a higher impairment on total venous return and its negative consequences on cardiac output.
| Original language | English |
|---|---|
| Pages (from-to) | 349-353 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Surgery |
| Volume | 51 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 1 2016 |
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Keywords
- CMV
- Congenital diaphragmatic hernia
- conventional mechanical ventilation
- HFOV
- high-frequency oscillatory ventilation
- NIRS
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
Cite this
Effects of ventilation modalities on near-infrared spectroscopy in surgically corrected CDH infants. / Conforti, Andrea; Giliberti, Paola; Landolfo, Francesca; Valfrè, Laura; Columbo, Claudia; Mondi, Vito; Capolupo, Irma; Dotta, Andrea; Bagolan, Pietro.
In: Journal of Pediatric Surgery, Vol. 51, No. 3, 01.03.2016, p. 349-353.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of ventilation modalities on near-infrared spectroscopy in surgically corrected CDH infants
AU - Conforti, Andrea
AU - Giliberti, Paola
AU - Landolfo, Francesca
AU - Valfrè, Laura
AU - Columbo, Claudia
AU - Mondi, Vito
AU - Capolupo, Irma
AU - Dotta, Andrea
AU - Bagolan, Pietro
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue oxygenation and perfusion. The aim of this study was to evaluate cerebral and splanchnic NIRS changes in CDH operated infants enrolled into the VICI trial and therefore randomized for ventilatory modalities. Materials and methods CDH newborns enrolled into the VICI trial (Netherlands Trial Register, NTR 1310) were randomized at birth for high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) according to the trial. Cerebral oxygenation (rSO2C) and splanchnic oxygenation (rSO2S) were obtained by NIRS (INVOS 5100; Somanetics, Troy, MI) before and after surgery. Variations in rSO2C and rSO2S were evaluated. Mann-Whitney test and one-way ANOVA were used as appropriate. p <0.05 was considered significant. Results Thirteen VICI trial patients underwent surgical repair between March 2011 and December 2012, and were enrolled in the study. Seven patients were assigned to HFOV and six to CMV group respectively. During surgery, a significant reduction in rSO2C (p = 0.0001) and rSO2S (p = 0.005) were observed. HFOV patients experienced prolonged reduction in rSO2C value (p = 0.003) while rSO2S did not vary between HFOV and CMV (p = 0.94). Conclusions Surgical CDH repair was associated with decrease of cerebral and splanchnic oxygenation, regardless of ventilation. Patients ventilated by HFOV need a longer time interval to recovery normal rSO2C values, than those ventilated by CMV. This may be owing to a different impact of HFOV on patients' hemodynamic status with a higher impairment on total venous return and its negative consequences on cardiac output.
AB - Background Near-infrared spectroscopy (NIRS) is a noninvasive technique for monitoring tissue oxygenation and perfusion. The aim of this study was to evaluate cerebral and splanchnic NIRS changes in CDH operated infants enrolled into the VICI trial and therefore randomized for ventilatory modalities. Materials and methods CDH newborns enrolled into the VICI trial (Netherlands Trial Register, NTR 1310) were randomized at birth for high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) according to the trial. Cerebral oxygenation (rSO2C) and splanchnic oxygenation (rSO2S) were obtained by NIRS (INVOS 5100; Somanetics, Troy, MI) before and after surgery. Variations in rSO2C and rSO2S were evaluated. Mann-Whitney test and one-way ANOVA were used as appropriate. p <0.05 was considered significant. Results Thirteen VICI trial patients underwent surgical repair between March 2011 and December 2012, and were enrolled in the study. Seven patients were assigned to HFOV and six to CMV group respectively. During surgery, a significant reduction in rSO2C (p = 0.0001) and rSO2S (p = 0.005) were observed. HFOV patients experienced prolonged reduction in rSO2C value (p = 0.003) while rSO2S did not vary between HFOV and CMV (p = 0.94). Conclusions Surgical CDH repair was associated with decrease of cerebral and splanchnic oxygenation, regardless of ventilation. Patients ventilated by HFOV need a longer time interval to recovery normal rSO2C values, than those ventilated by CMV. This may be owing to a different impact of HFOV on patients' hemodynamic status with a higher impairment on total venous return and its negative consequences on cardiac output.
KW - CMV
KW - Congenital diaphragmatic hernia
KW - conventional mechanical ventilation
KW - HFOV
KW - high-frequency oscillatory ventilation
KW - NIRS
UR - http://www.scopus.com/inward/record.url?scp=84960366661&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84960366661&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2015.07.021
DO - 10.1016/j.jpedsurg.2015.07.021
M3 - Article
AN - SCOPUS:84960366661
VL - 51
SP - 349
EP - 353
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 3
ER -