DETERMINATION OF THE LEVEL OF INTESTINAL WALL HYPOXIA DURING SURGICAL TREATMENT OF NECROTIZING ENTEROCOLITIS USING NEAR-INFRARED SPECTROSCOPY

Abstract

The article provides information about studies conducted to study the capabilities of a nearinfrared spectrometer in determining the level of hypoxia of the intestinal wall due to necrotizing enterocolitis in premature infants. The study included 47 premature children with necrotizing enterocolitis (NEC) 3A and 3B according to the Bell classification (main group), without abdominal wall defects, and 28 premature children with NEC A1 in the comparison group. The diagnosis of NEC was established on the basis of radiation diagnostic methods, objective clinical and laboratory examination, carried out immediately. The level of oxygenation of visceral tissues was determined using a near-infrared spectrometer INVOS 5100C (Covidien, Mansfield, USA) using neonatal sensors (NIRS - near-infrared spectroscopy). After determining the SpO2 level, the fractional level of oxygen remaining in the tissues was calculated using the formula FTOE = (SpO2 –rSO2)/SpO2. Studies have shown that decreased oxygenation of abdominal tissues and increased extraction of oxygen from visceral tissues lead to profound hypoxia, which can cause necrotic changes in the intestinal wall, which can lead to perforation of the intestinal wall and death. Thanks to NIRS monitoring, the severe stage of NEC can be distinguished from the mild form already in the first 24-32 hours. Thus, this research method can be used to determine the indications for surgery for this pathology.