Regional tissue oxygenation in preterm born infants in association with echocardiographically significant patent ductus arteriosus.
OBJECTIVE
To analyze the levels of regional tissue oxygenation in preterm infants in association with echocardiographically significant patent ductus arteriosus (PDA).


METHODS
Preterm infants with gestational age less than 32 week were enrolled before the first dose of the pharmacological treatment for the PDA. Non-invasive near-infrared spectroscopy (NIRS) technology was utilized to measure cerebral (rSO(2)-C), renal (rSO(2)-R) and mesenteric (rSO(2-M)) tissue oxygenation for approximately 60 min. Regional fractional oxygen extraction (FOE) was calculated using simultaneously measured arterial saturation (SaO(2)). We analyzed regional tissue oxygenation and oxygen extraction, hemodynamic parameters, and demographic and clinical information in association with the size of the PDA (moderate vs large).


RESULTS
Among the 38 enrolled infants, the majority were diagnosed with a large (63.2%, n=24) and the rest with a moderate-sized PDA. Infants with large and moderate PDA were comparable in terms of gestational age, study age and weight, mode of delivery and hemodynamic parameters. A significantly higher proportion of infants with a moderate PDA were mechanically ventilated as compared with those with a large PDA. We found no significant differences in the rSO(2)-C and rSO(2)-R, irrespective of the type of respiratory support. However, in infants with a large PDA on continuous nasal positive airway pressure (NCPAP), the rSO(2)-M was lower and mesenteric FOE was higher than that in mechanically ventilated neonates with a large PDA, and in those with moderate PDA irrespective of the type of respiratory support.


CONCLUSIONS
The PDA size did not affect cerebral and renal tissue oxygenation, but the mesenteric tissue oxygenation was decreased in infants with a large PDA on NCPAP.
Department of Pediatrics, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019, USA. petroran@umdnj.edu
A
A
Petrova
M
M
Bhatt
R
R
Mehta
D000704:Analysis of Variance; D002560:Cerebrovascular Circulation / Q000502:physiology; D015331:Cohort Studies; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012039:Regional Blood Flow; D012044:Regression Analysis; D012079:Renal Circulation / Q000502:physiology; D019265:Spectroscopy, Near-Infrared; D013152:Splanchnic Circulation / Q000502:physiology
D016861:Cyclooxygenase Inhibitors