Traditional vital signs in the neonatal patient include temperature, heart rate, respiratory rate and blood pressure. Invasive monitoring in the neonate is technically challenging. Shock often remains underrecognised and treated late, with resultant ischaemic end-organ damage, which may lead to death. Cerebral and somatic oximetry measures mixed venous and capillary oxygenation, reflective of end-organ (regional) oxygenation. By measuring cerebral and somatic saturation, early aberrations in regional blood flow can be identified, allowing for interventions before the development of the major manifestations of shock.
Objectives To utilise cerebral and somatic oximetry for early detection of shock states, guidance and assessment of therapeutic interventions and predicting complications and outcomes.
Methods Following the purchase of five cerebral/somatic oximeters, health practitioner education was undertaken and single and multisite near infrared spectroscopy monitoring begun. A registry was formed to allow for data collection, including patient demographic data and oximetry data.
Results To date, approximately 70 patients have been monitored. Individual cases illustrate the potential benefits of cerebral and somatic oximetry in the neonatal intensive care unit (NICU).
Conclusions As cerebral and somatic oximetry becomes more commonplace in the NICU, patient management and outcomes should improve. As a research tool, the use of regional oxygenation monitoring will provide valuable insights into the unique physiology of the term and preterm infant.
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