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Devang H. Akotia, Jayson T. Durham, Kathy M. Arnell, Deborah L. Petruzzelli, Anup C. Katheria
(Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA)
Med Sci Monit 2016; 22:61-68
Near-infrared spectroscopy (NIRS) has the potential to continuously and noninvasively monitor intestinal function. This technology may be valuable because among neonates, intestinal maturity is highly variable and difficult to assess based solely on clinical signs. The aim of this study was to determine if there is an association between NIRS-based StO2 measurements and peristaltic activity assessed by transabdominal ultrasonography (US).
MATERIAL AND METHODS: Nineteen neonates of gestational age >32 weeks were categorized according to “no/low” versus “normal/hyperactive” motility levels, based on blinded US scan results. StO2 was recorded every 2 s for 24 h, following the ultrasound recording. Differences between the resulting estimates of average StO2 (bias of fits) and goodness-of-fit (residuals) were evaluated.
RESULTS: Newborns with normal/hyperactive motility had higher mean StO2 than newborns with no/low motility (72.3±4.4 vs. 65.5±7.9, p<0.05, F=5.65). Residual errors were not significantly different between the 2 groups (p=0.213, F=0.213). A multivariate linear regression model using the means, residuals, and pairwise products of both, demonstrated more significant separation (0.47±0.26 vs. –0.24±0.33, p<0.01, F=27.4). A non-linear variant of the multivariate linear regression model demonstrated greatest separation (0.68±0.24 vs. –0.49±0.53, p<0.01, F=41.9).
CONCLUSIONS: This is the first study to demonstrate an association between NIRS-based StO2 measurements and peristaltic activity visualized by ultrasound imaging. NIRS may offer a continuous, noninvasive method to assess motility. This may have significant implications in premature infants at risk for feeding intolerance or necrotizing enterocolitis.
Keywords: Gastrointestinal Motility, Enterocolitis, Necrotizing - diagnostic imaging, Infant, Newborn, Infant, Premature, Diseases - diagnostic imaging, Intestines - diagnostic imaging, Monitoring, Physiologic - methods, Multivariate Analysis, Neonatology - methods, Oximetry, Oxygen - analysis, Peristalsis, Pilot Projects, Predictive Value of Tests, Reproducibility of Results, Spectroscopy, Near-Infrared, Splanchnic Circulation, Ultrasonography, Validation Studies as Topic