RESUMO
BACKGROUND: Diagnosis of necrotizing enterocolitis (NEC) in preterm neonates is challenging. We hypothesized that regional splanchnic oxygen saturation (rsSO2) measured by near-infrared spectroscopy (NIRS) is a biomarker for mesenteric perfusion. OBJECTIVE: To evaluate feasibility and safety of continuous rsSO2 monitoring in preterm infants in the first 14 days of life. METHODS: Preterm neonates ≤30 weeks' gestation had a NIRS sensor placed in the left paraumbilical region within 48 h of birth. rsSO2 was recorded every 30 s. Clinical data including pulse oximetry (SaO2) were recorded. Fractional tissue oxygen extraction (FTOE) was computed as follows: (SaO2 - rsSO2) × 100/SaO2. RESULTS: Of 21 infants enrolled, 2 were excluded because of skin breakdown and missing data. Daily mean rsSO2 values decreased over the first 9 days (p < 0.0001) followed by an increase from day 10 (D10) to D14 (p = 0.0061). rsSO(2) was lower and FTOE was higher in infants with feeding intolerance compared to those without feeding intolerance (p = 0.0043). rsSO2 accounted for ≥99.5% of the variance in FTOE. Two neonates with NEC had persistently low rsSO2 with loss of variability preceded or followed by very high rsSO2. CONCLUSIONS: We have reported feasibility, safety and ranges for rsSO2 for a small number of preterm infants in the first 2 weeks of life.