The influence of artificial CO2 pneumoperitoneum and pneumothorax on tissue oxygenation and microcirculation in neonates: A pilot-study with Near InfraRed Spectroscopy and Sidestream Dark Field Image Analysis

Minimal access surgery has many advantages. Less trauma to body-tissues means
smaller scars and faster post-operative recovery. In neonates, CO2
pneumoperitoneum and pneumothorax have a major effect on hemodynamics. Acidosis
occurs, and measuring tissue-oxygenation is done by bloodgas analysis. The
intermittent sampling causes lacunae in the information about the oxygenation
of brain and other organs.
Whether less trauma to tissues leads to a decreased hormonal stress-respons is
unknown. Insufflation of CO2 might also be a stressor, but it's effect on
stress-hormone levels is unknown.

To evaluate the tissue-oxygenation and microcirculation before, during and
after application of artificial pneumoperitoneum/-thorax using Near Infrared
Spectroscopy (NIRS) and Sidestream Dark Field Imaging (SDF) and validate the
usefulness of these techniques in monitoring neonates during Minimal Access
Surgery. This will result in follow-up studies where these measurements will be
used to make therapeutical interventions.
To compare the hormonal stress response during and after endoscopic surgery
with historic data we have from neonates undergoing the corresponding open
surgical procedures

Single-centre, non-randomized, observational study

All measurements will be done under anesthesia. Measurements are non-invasive,
no radiation is involved. A small quantity of blood will be collected for
determination of stress-hormone levels.