Absorption spectra of early stool from preterm infants need to be considered in abdominal NIRS oximetry.

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency of the preterm infant. Low abdominal tissue oxygen saturation (StO2) measured by near-infrared spectroscopy (NIRS) oximetry may be an early sign of NEC relevant for treating or even preventing NEC. However, current commercial NIRS oximeters provide inaccurate StO2 readings because they neglect stool as an abdominal absorber. To tackle this problem, we determined the optical properties of faeces of preterm infants to enable a correct abdominal StO2 measurement. In 25 preterm born infants (median age 31 0/7 ± 2 1/7 weeks, weight 1478 ± 511 g), we measured their first five stool probes with a VIS/NIR spectrometer and calculated the optical properties using the Inverse Adding Doubling (IAD) method. We obtained two absorption spectra representing meconium and transitional stool. Probabilistic cluster analysis correctly classified 96 out of 107 stool probes. The faeces spectra need to be considered to enable correct abdominal StO2 measurements with NIRS oximetry.

Carag bioresorbable septal occluder (CBSO): histopathology of experimental implants.

AIMS: The aim of this study was to evaluate local biological responses to the partially bioresorbable nonmetal frame Carag bioresorbable septal occluder system in an experimental setting. METHODS AND RESULTS: A Good Laboratory Practices (GLP) study was performed with implantation of the device into the interatrial septum of 24 German Landrace pigs with follow-up periods of 3, 5, 8 and 15 months (six animals in each group). One non-implant-related death occurred one month after implantation. Histology was obtained by sawing and grinding of the hard-resin embedded specimen after formalin fixation. All occlusion devices were found correctly positioned without any residual shunt at the end of the experiments. Complete endothelialisation could be confirmed histologically in all specimens independent of implantation period. There were only a few lymphocytic infiltrations locally related to the implant materials. Sporadic macrophages and foreign body giant cells were found adjacent to the textile fabric. Resorption of the biodegradable frame material was seen to proceed with implantation time. CONCLUSIONS: This is the first report on histopathology of a septal defect occluder with a bioresorbable filament structure in vivo which is already in clinical use. Good biocompatibility was demonstrated with documentation of timely degradation and substitution of the polymer material by fibromuscular cells and extracellular matrix components.

ASD and PFO closure with the Solysafe septal occluder - results of a prospective multicenter pilot study.

OBJECTIVE: We report the results of a prospective multicenter pilot study performed in Germany, Sweden, and Switzerland with a new self-centering device for transcatheter closure of an atrial septal defect (ASD) or a patent foramen ovale (PFO) called the Solysafe Septal Occluder. INTERVENTIONS: The device was successfully implanted in 44 patients. In 15 patients with a median age of 40 years (range 6-76 years), a Solysafe device was successfully implanted in an ASD. The median size of the stretched defects was 17 mm (range 10-21 mm). Three 15-mm devices, eight 20-mm devices, and four 25-mm devices were used. Procedure time ranged from 40 to 107 min (median 66 min) and fluoroscopic time from 5.3 to 17.5 min (median 12 min). In 29 patients with a median age of 47 years (range 15-78 years), a Solysafe device was implanted in a PFO. The procedure time ranged from 21 to 155 min (median 51 min) and fluoroscopic time from 3.1 to 31.3 min (median 7.6 min). RESULTS: At discharge, 1 of the 29 patients (3%) had a small shunt. No patient in either the ASD or the PFO group had any major complication. Six months after implantation, the overall closure rate with the Solysafe septal occluder in both groups was 100% (44/44). CONCLUSION: With the self-centering Solysafe Septal Occluder, PFOs, and ASDs with a stretched diameter of up to 21 mm can be effectively closed with very high occlusion rates.