Oxygenation Status in Critically Ill Newborns

Abstract

Prediction of neonates' critical states outcome depending on lab test findings and clinical manifestations is one of the most important and difficult problems of modern critical care medicine.Aim of the study. To evaluate changes in lab test findings and clinical manifestations in order to create individual timelines for critically ill neonates.Material and methods.We examined 229 neonates with a gestational age of 25—42 weeks. Babies' health was assessed daily throughout their ICU stay using 105 parameters. Six patients enrolled in the study died, 220 enrolled patients survived. We analyzed 24 quantitative attributes affected by variable factor «Outcome» (according to the univariate variance analysis) that reflects early outcomes of a critical state.Results. The study demonstrated that the main characteristics reflecting the severity of patient's condition and determining the outcome of a critical state are such parameters of the oxygenation status as total blood oxygen concentration, oxygen delivery index, oxygenation index, oxygen consumption index, and arterial oxygen extraction tension. The study demonstrated that neonates with favorable outcomes presented a steady increase in the oxygenation status parameters with concurrent decrease in the oxygenation index. At the same time, neonates with unfavorable out comes presented a steady decrease in the oxygen status parameters along with a significant increase in the oxygenation index. We determined that the arterial oxygen extraction tension did not comply with the reference limits even in case of a favorable outcome. The study demonstrated that a decrease in the oxygen consumption index in the unfavorable outcome group reflects a decrease in the metabolic rate in patient and indicates a terminal state of the disease.Conclusion. The assessment of tissue oxygen consumption variations with time permits to estimate the effectiveness of the intensive care, create individual timelines, and predict outcome on an individual basis.

Keywords

• neonate
• critical state
• oxygenation status
• timeline
• early outcome