ORIGINAL ARTICLE

Effect of limb cooling on peripheral and global oxygen consumption in neonates

I A-A Hassan¹, Y A Wickramasinghe² and S A Spencer¹

¹ Neonatal Unit, City General Hospital, Stoke on Trent, UK
² Centre for Science and Technology in Medicine, University of Keele, UK

Correspondence to:
Correspondence to:
Dr Spencer, Neonatal Unit, Maternity Building, North Staffordshire Hospital (City General), Newcastle Road, Stoke on Trent ST4 6QG, UK;
andy.spencer{at}nstaffsh.wmids.nhs.uk

Aim: To evaluate peripheral oxygen consumption (VO₂) measurements using near infrared spectroscopy (NIRS) with arterial occlusion in healthy term neonates by studying the effect of limb cooling on peripheral and global VO₂.

Subjects and methods: Twenty two healthy term neonates were studied. Peripheral VO₂ was measured by NIRS using arterial occlusion and measurement of the oxyhaemoglobin (HbO₂) decrement slope. Global VO₂ was measured by open circuit calorimetry. Global and peripheral VO₂ was measured in each neonate before and after limb cooling.

Results: In 10 neonates, a fall in forearm temperature of 2.2°C (mild cooling) decreased forearm VO₂ by 19.6% (p < 0.01). Global VO₂ did not change. In 12 neonates, a fall in forearm temperature of 4°C (moderate cooling) decreased forearm VO₂ by 34.7% (p < 0.01). Global VO₂ increased by 17.6% (p < 0.05).

Conclusions: The NIRS arterial occlusion method is able to measure changes in peripheral VO₂ induced by limb cooling. The changes are more pronounced with moderate limb cooling when a concomitant rise in global VO₂ is observed. Change in peripheral temperature must be taken into consideration in the interpretation of peripheral VO₂ measurements in neonates.

Keywords: limb cooling; oxygen consumption; metabolic rate

Abbreviations: VO₂, oxygen consumption; NIRS, near infrared spectroscopy; HbO₂, oxygenated haemoglobin; HbT, total haemoglobin; CI, confidence interval

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This article has been cited by other articles:

• Wickramasinghe, Y, Spencer, S A (2004). Quantification of peripheral oxygen consumption by near infrared spectroscopy. Arch. Dis. Child. Fetal Neonatal Ed. 89: F469-F470 [Full Text]