Noninvasive assessments of oxygen delivery from the microcirculation to skin in hypothermia-treated asphyxiated newborn infants

Abstract

This study indicates that assessments of skin microvascular density, capillary flow velocity, and oxygen extraction can be used to characterize reduced oxygen delivery to cells during TH.

Cooling Effect on Skin Microcirculation in Asphyxiated Newborn Infants with Increased C-Reactive Protein

“…The chest skin at the midline between the suprasternal notch and left nipple was examined within 24 h following the initiation of TH (day 1), the last day of TH (day 3) and within 24 h after rewarming (day 4) with the child in an open incubator in a dimmed room [11]. The first five films were recorded from the chest (CAVM), then seven LDPMs and finally 12 measurements with the spectroscope (DRS) were performed.…”

“…STS-101-C, Omega Medical, Stanford, Calif., USA) was measured immediately before the microcirculatory examinations. Further details about the different microcirculatory methods have been described previously [11]. An NIRS sensor (INVOS 5100C, Somanetics, Troy, Mich., USA) was placed on the forehead region and continuous cerebral oxygen saturations were performed while the other measurements were collected.…”

“…Microcirculatory data from an overall group of 28 HIE infants have been published previously [11]. In the present study analyses between two subgroups of those 28 HIE infants were performed depending on CRP values associated with a high or low degree of systemic inflammation (table 1).…”

“…The NIRS measuring volume corresponds to approximately 2-3 cm 3 with a measuring depth of 1-3 cm, depending on the probe design [10]. With the intention to primarily assess the nutritive capillaries in the skin, we have tested three different noninvasive techniques: laser Doppler perfusion measurements (LDPMs), computer-assisted video microscopy (CAVM) and diffuse reflectance spectroscopy (DRS) [11]. The measuring volume of CAVM and DRS is less than 1 mm 3 , corresponding to a measuring depth of approximately 0.8 mm in the skin [12].…”

“…We found microcirculatory alterations during cooling with normalization in most infants after rewarming [11]. However, in about a third, the microcirculatory alterations were even reinforced after regaining normal body temperature.…”