Abstract
Objective:
To analyze the levels of regional tissue oxygenation in preterm infants in association with echocardiographically significant patent ductus arteriosis (PDA).
Study Design:
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 (rSO2-C), renal (rSO2-R) and mesenteric (rSO2-M) tissue oxygenation for approximately 60 min. Regional fractional oxygen extraction (FOE) was calculated using simultaneously measured arterial saturation (SaO2). 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).
Result:
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 rSO2-C and rSO2-R, irrespective of the type of respiratory support. However, in infants with a large PDA on continuous nasal positive airway pressure (NCPAP), the rSO2-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.
Conclusion:
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.
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Acknowledgements
We would like to express our most sincere appreciation for the infants and their families for participation and commitment to this research project. This study was funded in part by a grant from Ovation Pharmaceuticals.
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Each of the three co-authors has made substantive intellectual contribution to the study (conception and design, acquisition of data, or analysis and interpretation of data, drafting of the manuscript or revising it critically for important intellectual content) and takes public responsibility for appropriate portions of the content of the manuscript.
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Petrova, A., Bhatt, M. & Mehta, R. Regional tissue oxygenation in preterm born infants in association with echocardiographically significant patent ductus arteriosus. J Perinatol 31, 460–464 (2011). https://doi.org/10.1038/jp.2010.200
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DOI: https://doi.org/10.1038/jp.2010.200
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