Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport.
<h4>Objective</h4>The aim of the current study was to investigate how cerebral and splanchnic oxygen saturation (rSO2-C and rSO2-A) in critically ill children transported in air ambulance was affected by flight with cabin pressurization corresponding to ≥ 5000 feet. A second aim was to i...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0239272 |
| _version_ | 1818725995943821312 |
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| author | Tova Hannegård Hamrin Staffan Eksborg Jonas Berner Urban Fläring Peter J Radell |
| author_facet | Tova Hannegård Hamrin Staffan Eksborg Jonas Berner Urban Fläring Peter J Radell |
| author_sort | Tova Hannegård Hamrin |
| collection | DOAJ |
| description | <h4>Objective</h4>The aim of the current study was to investigate how cerebral and splanchnic oxygen saturation (rSO2-C and rSO2-A) in critically ill children transported in air ambulance was affected by flight with cabin pressurization corresponding to ≥ 5000 feet. A second aim was to investigate any differences between cyanotic and non-cyanotic children in relation to cerebral and splanchnic oxygen saturation during flight ≥ 5000 feet. The variability of the cerebral and splanchnic Near Infrared Spectroscopy (NIRS) sensors was evaluated.<h4>Design</h4>NIRS was used to measure rSO2-C and rSO2-A during transport of critically ill children in air ambulance. rSO2 data was collected and stored by the NIRS monitor and extracted and analyzed off-line after the transport. Prior to evaluation of the NIRS signals all zero and floor-effect values were removed.<h4>Setting</h4>The Pediatric Intensive Care Unit (PICU) at Astrid Lindgren Children's Hospital, Karolinska University Hospital in Stockholm, Sweden.<h4>Patients</h4>In total, 44 critically ill children scheduled for inter-hospital transport by a specialized pediatric transport team were included in the study between January 2014 and January 2019 (convenience sampling).<h4>Intervention</h4>No interventions were conducted.<h4>Measurements</h4>All study patients were monitored with a cerebral NIRS-sensor placed over the forehead and an abdominal NIRS-sensor placed in the infra-umbilical area for cerebral and splanchnic regional oxygen saturation monitoring, rSO2-C and rSO2-A, respectively.<h4>Main results</h4>Complete rSO2-C and rSO2-A data was obtained in 39 patients. Median age was 12 days. Cyanotic congenital heart malformations were present in 9 patients (23%). In 22 patients (56%) rSO2-C decreased at altitude ≥ 5000 feet and in 24 patients (61%) rSO2-A decreased at altitude ≥ 5000 feet compared to baseline (p<0.0001). In 25 patients (64%) the rSO2-C/rSO2-A ratio was greater at altitude ≥ 5000 feet than at baseline. A ratio ≥ 1 was seen in 77% of patients at altitude ≥ 5000 feet compared to in 67% of patients at baseline.<h4>Conclusion</h4>Both cerebral and splanchnic oxygen saturation decreased at altitude ≥ 5000 feet compared to baseline. In most patients, both cyanotic and non-cyanotic, cerebral oxygen saturation was preserved more than splanchnic oxygen saturation. |
| first_indexed | 2024-12-17T21:51:10Z |
| format | Article |
| id | doaj.art-4dc2295de8c143b3a22b313e7fabb89f |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T21:51:10Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-4dc2295de8c143b3a22b313e7fabb89f2022-12-21T21:31:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159e023927210.1371/journal.pone.0239272Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport.Tova Hannegård HamrinStaffan EksborgJonas BernerUrban FläringPeter J Radell<h4>Objective</h4>The aim of the current study was to investigate how cerebral and splanchnic oxygen saturation (rSO2-C and rSO2-A) in critically ill children transported in air ambulance was affected by flight with cabin pressurization corresponding to ≥ 5000 feet. A second aim was to investigate any differences between cyanotic and non-cyanotic children in relation to cerebral and splanchnic oxygen saturation during flight ≥ 5000 feet. The variability of the cerebral and splanchnic Near Infrared Spectroscopy (NIRS) sensors was evaluated.<h4>Design</h4>NIRS was used to measure rSO2-C and rSO2-A during transport of critically ill children in air ambulance. rSO2 data was collected and stored by the NIRS monitor and extracted and analyzed off-line after the transport. Prior to evaluation of the NIRS signals all zero and floor-effect values were removed.<h4>Setting</h4>The Pediatric Intensive Care Unit (PICU) at Astrid Lindgren Children's Hospital, Karolinska University Hospital in Stockholm, Sweden.<h4>Patients</h4>In total, 44 critically ill children scheduled for inter-hospital transport by a specialized pediatric transport team were included in the study between January 2014 and January 2019 (convenience sampling).<h4>Intervention</h4>No interventions were conducted.<h4>Measurements</h4>All study patients were monitored with a cerebral NIRS-sensor placed over the forehead and an abdominal NIRS-sensor placed in the infra-umbilical area for cerebral and splanchnic regional oxygen saturation monitoring, rSO2-C and rSO2-A, respectively.<h4>Main results</h4>Complete rSO2-C and rSO2-A data was obtained in 39 patients. Median age was 12 days. Cyanotic congenital heart malformations were present in 9 patients (23%). In 22 patients (56%) rSO2-C decreased at altitude ≥ 5000 feet and in 24 patients (61%) rSO2-A decreased at altitude ≥ 5000 feet compared to baseline (p<0.0001). In 25 patients (64%) the rSO2-C/rSO2-A ratio was greater at altitude ≥ 5000 feet than at baseline. A ratio ≥ 1 was seen in 77% of patients at altitude ≥ 5000 feet compared to in 67% of patients at baseline.<h4>Conclusion</h4>Both cerebral and splanchnic oxygen saturation decreased at altitude ≥ 5000 feet compared to baseline. In most patients, both cyanotic and non-cyanotic, cerebral oxygen saturation was preserved more than splanchnic oxygen saturation.https://doi.org/10.1371/journal.pone.0239272 |
| spellingShingle | Tova Hannegård Hamrin Staffan Eksborg Jonas Berner Urban Fläring Peter J Radell Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport. PLoS ONE |
| title | Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport. |
| title_full | Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport. |
| title_fullStr | Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport. |
| title_full_unstemmed | Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport. |
| title_short | Influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport. |
| title_sort | influence of altitude on cerebral and splanchnic oxygen saturation in critically ill children during air ambulance transport |
| url | https://doi.org/10.1371/journal.pone.0239272 |
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