{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:42:53Z","timestamp":1770741773890,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T00:00:00Z","timestamp":1632182400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Titration of inspired oxygen is a challenge in preterm infants with hypoxemic respiratory failure (HRF). Monitoring of brain oxygen by near\u2010infrared spectroscopy (NIRS) has been proven to minimize the burden of hyperoxia and hypoxemia; with a better understanding of cerebral autoregulation, integrating NIRS and pulse oximetry for titrating inspired oxygen in preterm infants is a novel approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied the impact of integrated monitoring of oxygen saturation by pulse oximetry (SpO<jats:sub>2<\/jats:sub>) and cerebral regional tissue oxygen (crRTO) by NIRS during a stepwise oxygen reduction test (ORT) on reducing oxygen requirement in preterm infants with HRF. The correlation between SpO<jats:sub>2<\/jats:sub> with crRTO, and fractional oxygen extraction (FOE) was assessed, concordance levels (<jats:italic>r<\/jats:italic>\u2009&gt;\u20090.5) were determined during the assessment period and were considered as a sign of impaired autoregulation. The primary outcome was the achievement of significantly lower FiO<jats:sub>2<\/jats:sub> at 72\u2009h after the start of the integrated monitoring.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 38 preterm infants were included, 27 had normal cerebral autoregulation (CAR)\u00a0(Group 1) in whom SpO<jats:sub>2<\/jats:sub> was poorly correlating with crRTO\u00a0with (<jats:italic>r<\/jats:italic>\u2009&lt;\u20090.5) and had a significantly greater percentage of reduction below baseline in FiO<jats:sub>2<\/jats:sub> (mean: 34%). Eleven infants had impaired CAR (Group 2) with SpO<jats:sub>2<\/jats:sub> significantly correlating with crRTO (<jats:italic>r<\/jats:italic>\u2009&gt;\u20090.5) and had a linear trend of FOE inverse to SpO<jats:sub>2<\/jats:sub> and crRTO; this was considered as an arterial saturation dependent oxygen delivery (SadDO<jats:sub>2<\/jats:sub>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Integrated monitoring of preterm infants by SpO<jats:sub>2<\/jats:sub> and crRTO was associated with easier weaning of oxygen with less burden of both hyperoxia and hypoxemia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ppul.25673","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T21:16:18Z","timestamp":1632258978000},"page":"3870-3878","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Titration of inspired oxygen in preterm infants with hypoxemic respiratory failure using near\u2010infrared spectroscopy and pulse oximetry: A new approach"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7989-0285","authenticated-orcid":false,"given":"Yasser N.","family":"Elsayed","sequence":"first","affiliation":[{"name":"Section of Neonatology University of Manitoba  Winnipeg Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7279-5226","authenticated-orcid":false,"given":"Shyamala","family":"Dakshinamurti","sequence":"additional","affiliation":[{"name":"Section of Neonatology University of Manitoba  Winnipeg Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-015-2643-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514212"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000356561"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.2000.279.2.L408"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.5555"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1247"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.07.063"},{"issue":"6","key":"e_1_2_10_9_1","first-page":"H864","article-title":"Sequential hemodynamic and oxygen transport responses in hypovolemia, anemia, and hypoxia","volume":"241","author":"Schwartz S","year":"1981","journal-title":"Am J Physiol"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.013051"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-71764-7_23"},{"issue":"3","key":"e_1_2_10_12_1","article-title":"Restricted versus liberal oxygen exposure for preventing morbidity and mortality in preterm or low birth weight infants. 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