Measurement of lung oxygenation by near-infrared spectroscopy in preterm infants with bronchopulmonary dysplasia

Abstract

Introduction: It has recently been reported that it is possible to monitor lung oxygenation (rSO₂ L) by near-infrared spectroscopy (NIRS) in preterm infants with respiratory distress syndrome (RDS). Thus, our aim was to assess the possibility of monitoring rSO₂ L in infants with evolving and established bronchopulmonary dysplasia (BPD) and to evaluate if rSO₂ L correlates with BPD severity and other oxygenation indices.

Methods: We studied 40 preterm infants with gestational age ≤30 weeks at risk for BPD. Patients were continuously studied for 2 h by NIRS at 28 ± 7 days of life and 36 weeks ± 7 days of postmenstrual age.

Results: rSO₂ L was similar at the first and second NIRS recordings (71.8 ± 7.2 vs. 71.4 ± 4.2%) in the overall population, but it was higher in infants with mild than in those with moderate-to-severe BPD at both the first (73.3 ± 3.1 vs. 71.2 ± 3.2%, p = .042) and second (72.3 ± 2.8 vs. 70.5 ± 2.8, p = .049) NIRS recording. A rSO₂ L cutoff value of 71.6% in the first recording was associated with a risk for moderate-to-severe BPD with a sensitivity of 66% and a specificity of 60%. Linear regression analysis demonstrated a significant positive relationship between rSO₂ L and SpO₂ /FiO₂ ratio (p = .013) and a/APO₂ (p = .004).

Conclusions: Monitoring of rSO₂ L by NIRS in preterm infants with evolving and established BPD is feasible and safe. rSO₂ L was found to be higher in infants with mild BPD, and predicts the risk for developing moderate-to-severe BPD and correlates with other indices of oxygenation.

Keywords: bronchopulmonary dysplasia; lung oxygenation; near-infrared spectroscopy; preterm infants.