Directly measured arterial oxygen saturation in the newborn infant

Ryan, C. Anthony; Barrington, Keith J.; Vaughan, Diane; Finer, Neil N.

doi:10.1016/s0022-3476(86)80137-8

Cited by 19 publications

(3 citation statements)

References 16 publications

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“…The only commonly used oximeter with animal coefficients, the IL282, does not include piglet blood settings. However, we have previously shown, when using these devices, that the apparent carboxyhemoglobin is erroneously elevated when using blood with very different optical characteristics [ 10 ]; the apparent carboxyhemoglobin levels in our piglets were almost always less than 2%, suggesting that the oxygen saturation values should be reliable. Furthermore, the trends shown are likely to be accurate, even if the actual values are somewhat imprecise.…”

Section: Discussionmentioning

confidence: 80%

The effects of dopamine and epinephrine on hemodynamics and oxygen metabolism in hypoxic anesthetized piglets

Cheung

Barrington

2001

Crit Care

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CI = cardiac index; EO 2 = oxygen extraction; HAFI = hepatic arterial flow index; hepatic DO 2 = hepatic oxygen delivery; hepatic DO 2 ratio = ratio of hepatic arterial oxygen delivery to total hepatic oxygen delivery; MVRI = mesenteric vascular resistance index; PAP = mean pulmonary arterial pressure; PVFI = portal venous flow index; PVRI = pulmonary vascular resistance index; S a O 2 = arterial saturation; SAP = mean systemic arterial pressure; S p O 2 = portal venous saturation; S v O 2 = mixed venous saturation; SVRI = systemic vascular resistance index; VO 2 = oxygen consumption; THFI = total hepatic flow index.Available online http://ccforum.com/content/5/3/158 AbstractBackground: The most appropriate inotropic agent for use in the newborn is uncertain. Dopamine and epinephrine are commonly used, but have unknown effects during hypoxia and pulmonary hypertension; the effects on the splanchnic circulation, in particular, are unclear. Methods: The effects on the systemic, pulmonary, hepatic, and mesenteric circulations of infusions of dopamine and epinephrine (adrenaline) were compared in 17 newborn piglets. Three groups [control (n = 5), dopamine (n = 6) and epinephrine (n = 6)] of fentanyl anesthetized newborn piglets were instrumented to measure cardiac index (CI), hepatic arterial and portal venous blood flow, mean systemic arterial pressure (SAP), mean pulmonary arterial pressure (PAP), and arterial, portal and mixed venous oxygen saturations. Systemic, pulmonary, and mesenteric vascular resistance indices [systemic vascular resistance index (SVRI), pulmonary vascular resistance index (PVRI), mesenteric vascular resistance index (MVRI)], and systemic and splanchnic oxygen extraction and consumption were calculated. Alveolar hypoxia was induced, with arterial oxygen saturation being maintained at 55-65%. After 1 h of stabilization during hypoxia, each animal received either dopamine or epinephrine; randomly administered doses of 2, 10, and 32 µg kg -1 min -1 and 0.2, 1.0, and 3.2 µg kg -1 min -1 respectively were infused for 1 h at each dose. Results were compared with the 1 h hypoxia values by two-way analysis of variance. Results: Epinephrine increased CI at all doses, with no significant effects on SAP and SVRI. Although epinephrine increased PAP at 3.2 µg kg -1 min -1 , it had no effect on PVRI. Dopamine had no effect on CI, SAP, and SVRI, but increased PAP at all doses and PVRI at 32 µg kg -1 min -1 . The SAP/PAP ratio was decreased with 32 µg kg -1 min -1 dopamine, whereas epinephrine did not affect the ratio. In the mesenteric circulation, dopamine at 32 µg kg -1 min -1 increased portal venous flow and total hepatic blood flow and oxygen delivery, and decreased MVRI; epinephrine had no effect on these variables. Epinephrine increased hepatic arterial flow at 0.2 µg kg -1 min -1 ; dopamine had no effect on hepatic arterial flow at any dose. Despite these hemodynamic changes, there were no differences in systemic or splanchnic oxygen extraction or consumption at any dose of dopamine or epinephrine. ...

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Section: Discussionmentioning

confidence: 80%

The effects of dopamine and epinephrine on hemodynamics and oxygen metabolism in hypoxic anesthetized piglets

Cheung

Barrington

2001

Crit Care

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“…The standard clinical protocol inclusion criteria for therapeutic hypothermia treatment of neonatal HIE at the Johns Hopkins Hospital NICU are birth ≥ 35 weeks gestation, physiologic criteria similar to that reported in the NICHD trials of whole body cooling ( 5 ), clinical evidence of HIE determined by clinical evaluation of consciousness, neuromuscular control, complex reflexes, autonomic function, and presence of seizures ( 19 , 20 ). Hypothermia therapy is initiated within 6 hours of birth.…”

Section: Methodsmentioning

confidence: 99%

Transfontanellar duplex brain ultrasonography resistive indices as a prognostic tool in neonatal hypoxic-ischemic encephalopathy before and after treatment with therapeutic hypothermia

et al. 2015

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OBJECTIVEPrior to therapeutic hypothermia (i.e., cooling), transfontanellar duplex brain sonography resistive indices (RI) were studied as bedside non-invasive measures of cerebral hemodynamics in neonates who suffered from hypoxic-ischemic encephalopathy (HIE). We compared pre- and post-cooling RI values and examined the relationships between RI values and specific long-term neurodevelopmental outcomes.STUDY DESIGNTransfontanellar duplex brain sonography, including RI, were obtained for 28 neonates prior to brain cooling and for 20 neonates following brain cooling. All RI values were sampled in the anterior cerebral artery at the beginning of each ultrasound study. Neurodevelopmental assessment was conducted between ages 20-32 months with the Mullen Scale of Early Learning. The relationships between pre- and post-cooling RI and cognitive and motor outcomes were studied.RESULTNeonates with RI values <0.60 prior to and following cooling were more likely to die or have severe neurodevelopmental disability by ages 20-32 months than those with RI >0.60. Lower RI values were associated with specific neurodevelopmental deficits in motor skill attainment.CONCLUSIONPre- and post-cooling transfontanellar duplex brain sonography RI values may be a useful prognostic tool, in conjunction with other clinical information, for neonates diagnosed with HIE. The results of this study suggest that further study of the prognostic value of RI values for short- and long-term outcomes is warranted.

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“…Percentage of fetal haemoglobin (HbF) is an important determinant for haemoglobin oxygen saturation (Sao 2 ). High HbF percentages can induce errors in determining Sao 2 as current co-oxymeters can mistake HbF for carboxyhaemoglobin [1].…”

mentioning

confidence: 99%

Accuracy of measurements of HbF with OSM3 in neonates and infants

Denjean¹,

Bridey²,

Jp³

et al. 1992

Eur Respir J

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The accuracy of the Radiometer OSM3 oxymeter for measurement of fetal haemoglobin (HbF) in infants was investigated, and compared to one of the standard reference methods using alkali electrophoresis of haemoglobin. Blood samples of 37 infants with different gestational (27-41 weeks) and postnatal (1-198 days) ages were analysed. The two methods gave very close results but a significant mean difference (range -4.5-16.5%). However, agreement between the two methods was judged clinically acceptable (95% limits of agreement -7.5-15.5%). A rapid determination of HbF percentage, using OSM3, is an important determinant for correct assessment of oxygen saturation in newborn infants in intensive care units.

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Directly measured arterial oxygen saturation in the newborn infant

Cited by 19 publications

References 16 publications

The effects of dopamine and epinephrine on hemodynamics and oxygen metabolism in hypoxic anesthetized piglets

The effects of dopamine and epinephrine on hemodynamics and oxygen metabolism in hypoxic anesthetized piglets

Transfontanellar duplex brain ultrasonography resistive indices as a prognostic tool in neonatal hypoxic-ischemic encephalopathy before and after treatment with therapeutic hypothermia

Accuracy of measurements of HbF with OSM3 in neonates and infants

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