Abstract
Background: The ability to monitor tissue oxygenation in neonates remains a challenge due to limited blood supply and the reliance on invasive procedures. Resonance Raman spectroscopy noninvasively measures tissue oxygenation (RRS-StO<sub>2</sub>). Peripheral tissue oxygenation using this novel technology has not been described in neonates. Objectives: To examine the relationship between short-term RRS-StO<sub>2</sub> measurements and central venous saturation (ScvO<sub>2</sub>) and pulse oximetry (SpO<sub>2</sub>) in preterm and term neonates. Methods: Ninety-seven term neonates had buccal and plantar RRS-StO<sub>2</sub> measurements performed. In 15 preterm neonates, similar measurements were obtained in conjunction with ScvO<sub>2</sub> in the first week of life. Simultaneous SpO<sub>2</sub> and heart rate were also recorded. Results: In healthy neonates, buccal RRS-StO<sub>2</sub> values negatively correlated with the day of life. No correlation existed between buccal and plantar RRS-StO<sub>2</sub> values and ScvO<sub>2</sub> or SpO<sub>2</sub>. Greater intra-patient plantar RRS-StO<sub>2</sub> variability was seen in preterm neonates with increasing respiratory support. Conclusions: Neonatal RRS-StO<sub>2</sub> measurements are feasible short term but do not correlate with ScvO<sub>2</sub> and SpO<sub>2</sub>. Healthy neonates had greater differences and variability in RRS-StO<sub>2</sub> values, illustrating an evolving microcirculation not detected with pulse oximetry. Greater RRS-StO<sub>2</sub> variability in sick neonates requiring respiratory support may indicate microcirculatory instability despite being within target SpO<sub>2</sub> ranges. Further study is needed to establish if RRS-StO<sub>2</sub> monitoring is an accurate representation of tissue oxygenation.
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