| C reactive protein: impact on peripheral tissue oxygenation and perfusion in neonates. | |
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MedLine Citation:
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PMID: 22294473 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ObjectiveC reactive protein (CRP) is a sensitive marker of acute inflammation of infectious and non-infectious origin. Aim was to use near-infrared spectroscopy (NIRS) to analyse peripheral oxygenation and perfusion in term and preterm neonates with elevated CRP levels, at a time when routine haemodynamic variables are still normal.DesignProspective observational study.SettingsPeripheral-muscle NIRS was performed in the first week of life. Tissue-oxygenation index (TOI), mixed venous oxygenation (SvO(2)), fractional oxygen extraction (FOE), haemoglobin flow (Hbflow), oxygen delivery (DO(2)) and oxygen consumption (VO(2)) were assessed. Blood samples were taken within 3 h of the NIRS measurements.PatientsCardiocirculatory stable term and preterm neonates with infection-related and infection-unrelated CRP elevations >10 mg/l were compared with neonates without CRP elevation. The two groups were matched for gestational and postnatal age.Results33 neonates with CRP elevation (gestational age 37.7±2.9 weeks) were compared with 33 controls (gestational age 37.3±2.9 weeks). In neonates with CRP elevation, TOI (68.9±6.6%), SvO(2) (66.9±7.3%) DO(2) (39.2±16.1 µmol/100ml/min) and VO(2) (10.9±3.4 µmol/100ml/min) were significantly lower compared with controls (TOI 72.9±3.8%, SvO(2) 70.2±4.7%, DO(2) 48.8±18.4 µmol/100ml/min, VO(2) 12.3±3.8 µmol/100ml/min). There was no significant difference in any other NIRS or routine haemodynamic parameter between the two groups.ConclusionInflammatory processes with CRP elevation cause impaired peripheral oxygenation and perfusion in neonates even when routine haemodynamic variables are still normal. NIRS might offer a new non-invasive tool for the early recognition and diagnosis of infectious and non-infectious inflammatory processes. |
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Authors:
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Gerhard Pichler; Mirjam Pocivalnik; Regina Riedl; Elisabeth Pichler-Stachl; Heinz Zotter; Wilhelm Müller; Berndt Urlesberger |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-1-31 |
Journal Detail:
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Title: Archives of disease in childhood. Fetal and neonatal edition Volume: - ISSN: 1468-2052 ISO Abbreviation: - Publication Date: 2012 Jan |
Date Detail:
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Created Date: 2012-2-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9501297 Medline TA: Arch Dis Child Fetal Neonatal Ed Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Department of Pediatrics, Medical University Graz, Graz, Austria. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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