Cerebral perfusion and assessing hemodynamic significance for patent ductus arteriosus using near infrared red spectroscopy in very low birth weight infants.

Autor: Poon WB; Department of Neonatal and Developmental Medicine, Singapore General Hospital, Bukit Merah, Singapore., Tagamolila V; Department of Neonatal and Developmental Medicine, Singapore General Hospital, Bukit Merah, Singapore.
Jazyk: angličtina
Zdroj: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians [J Matern Fetal Neonatal Med] 2021 May; Vol. 34 (10), pp. 1645-1650. Date of Electronic Publication: 2019 Jul 22.
DOI: 10.1080/14767058.2019.1644313
Abstrakt: Introduction/objective: To study the impact of hemodynamically significant patent ductus arteriosus (hsPDA), using near infrared red spectroscopy (NIRS) regional cerebral (SrO 2 ), renal (RrO 2 ) saturation measurements, and fractional tissue oxygenation extraction (FTOE) before and after medical and/or surgical treatment.
Methods: Prospective cohort study of very low birth weight (VLBW) preterm infants with hsPDA requiring treatment from March 2014 to December 2016 in a tertiary Neonatal Intensive Care Unit in Singapore. NIRS was applied at diagnosis until 24-48 h after the last dose of ibuprofen or postsurgical ligation. All PDAs were documented to be closed by echocardiography. Post-treatment values (control group) were compared against pretreatment values.
Results: Twenty-nine infants were studied, with mean gestational age of 26.7 weeks and birth weight of 956 g. Median day of life of PDA diagnosis was 4. Seven infants (24.1%) underwent PDA ligation. There was significant reduction in FTOE before treatment till after last dose of medication or ligation by a mean difference of 7.27% ( p  < .05). Reduction in FTOE was also found between the first dose of medication till after the last dose or ligation. Cerebral SrO 2 significantly increased between first dose of medication till last dose of medication by a mean difference of 3.09% ( p  = .034). RrSO2 values were not significantly affected. No correlation between NIRS values and PDA size was found.
Conclusions: Significant increase in cerebral SrO 2 and reduction in FTOE by NIRS post PDA closure in hemodynamically significant PDAs suggest that PDA closure may reduce cerebral hypoxia burden.
Databáze: MEDLINE
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