Regional tissue oxygenation in asymptomatic neonates at high risk for neonatal abstinence syndrome and impact of non-pharmacologic interventions: A case report
Affiliations: [a] Pediatrics, Boston Children’s Hospital, Boston, MA, USA
| [b] General Surgery, University of Hawaii, Honolulu, HI, USA
| [c] Pediatrics, Stony Brook Children’s, Stony Brook, NY, USA
| [d] Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA
| [e] Neonatology, Mountainside Medical Center, Montclair, NJ, USA
Correspondence:
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Address for correspondence: Sarah P. Justvig, MD, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA. E-mail: [email protected].
Abstract: BACKGROUND:Improving neonatal abstinence syndrome (NAS) management is an important concern, and objective measures of its physiologic impact remain elusive. We sought to determine whether near-infrared spectroscopy (NIRS)-derived tissue oxygenation (rSO2) and fractional tissue oxygen extraction (FTOE) demonstrated physiologically plausible changes correlating with standard NAS scoring. METHODS:Thirty subjects (mean 39 weeks’ GA and 3 127 g BW) underwent cerebral and peripheral muscle NIRS monitoring on Days of Life (DOL) Three, Five, and Seven. We examined correlations between NAS scores and FTOE and assessed the impact of non-pharmacologic swaddling and cuddling. RESULTS:No statistically significant correlations between NAS scores and FTOE were observed; however, plausible trends were demonstrated between NAS scores and cerebral measurements. Buprenorphine-exposed babies (57%) showed significantly lower FTOE when swaddled (DOL7). CONCLUSIONS:Tissue oxygenation monitoring demonstrates potential to provide objective, clinically relevant physiologic information on infants at risk for NAS. Further study is required to determine whether NIRS-derived measures could assist in individualizing NAS care.
