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Erschienen in: Journal of Clinical Monitoring and Computing 6/2022

20.04.2022 | Original Research

Changes in regional oxygen saturation of the kidney and brain of infants during hospitalization

verfasst von: Daisuke Yoshida, MD, Tomoyuki Shimokaze, MD, Atsushi Kondo, MD, Katsuaki Toyoshima, MD, Tomoko Saito, MD

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 6/2022

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Abstract

Background

In pre-term infants, the postnatal changes in the regional oxygen saturation (rSO2) of the brain and kidney are unclear.

Methods

We performed a prospective observational study. We measured the cerebral/renal rSO2 ratio and recorded the associated clinical features of infants born at 23 to 41 weeks of gestation weekly from the early postnatal period to discharge.

Results

The median cerebral/renal rSO2 ratios (interquartile ranges) between birth and the expected date of birth were 1.13 (1.06–1.26) at 23–24 weeks (n = 7), 1.18 (1.10–1.32) at 25–26 weeks (n = 11), 1.24 (1.11–1.37) at 27–28 weeks (n = 9), 1.12 (1.05–1.19) at 29–30 weeks (n = 4), 1.11 (1.03–1.15) at 31–32 weeks (n = 5), 1.02 (0.98–1.06) at 33–34 weeks (n = 9), 0.98 (0.94–1.06) at 35–36 weeks (n = 19), and 0.95 (0.86–0.99) at 37–41 weeks of gestation (n = 22). The median cerebral/renal rSO2 ratio did not significantly change after birth, but with increasing gestational age, the cerebral/renal rSO2 ratio at the expected date of birth decreased (r = − 0.74, p < 0.001). Nephrotoxic drugs did not affect cerebral/renal rSO2 at the expected date of birth, after adjustment for clinical factors.

Conclusions

Unlike in most infants born after the late pre-term period, the renal rSO2 remained lower than the cerebral rSO2 on the expected date of birth in infants born very pre-term.
Literatur
1.
Zurück zum Zitat Bernal NP, Hoffman GM, Ghanayem NS, Arca MJ. Cerebral and somatic near-infrared spectroscopy in normal newborns. J Pediatr Surg. 2010;45:1306–10.CrossRefPubMed Bernal NP, Hoffman GM, Ghanayem NS, Arca MJ. Cerebral and somatic near-infrared spectroscopy in normal newborns. J Pediatr Surg. 2010;45:1306–10.CrossRefPubMed
2.
Zurück zum Zitat Montaldo P, De Lenonibus C, Giordano L, De Vivo M, Giliberti P. Cerebral, renal and mesenteric regional oxygen saturation of term infants during transition. J Pediatr Surg. 2015;50:1273–7.CrossRefPubMed Montaldo P, De Lenonibus C, Giordano L, De Vivo M, Giliberti P. Cerebral, renal and mesenteric regional oxygen saturation of term infants during transition. J Pediatr Surg. 2015;50:1273–7.CrossRefPubMed
3.
Zurück zum Zitat Blohm ME, Obrecht D, Hartwich J, Singer D. Effect of cerebral circulatory arrest on cerebral near-infrared spectroscopy in pediatric patients. Pediatr Anesth. 2014;24:393–9.CrossRef Blohm ME, Obrecht D, Hartwich J, Singer D. Effect of cerebral circulatory arrest on cerebral near-infrared spectroscopy in pediatric patients. Pediatr Anesth. 2014;24:393–9.CrossRef
4.
Zurück zum Zitat Danduran MJ, Dixon JE, Rao RP. Near infrared spectroscopy describes physiologic payback associated with excess postexercise oxygen consumption in healthy controls and children with complex congenital heart disease. Pediatr Cardiol. 2012;33:95–102.CrossRefPubMed Danduran MJ, Dixon JE, Rao RP. Near infrared spectroscopy describes physiologic payback associated with excess postexercise oxygen consumption in healthy controls and children with complex congenital heart disease. Pediatr Cardiol. 2012;33:95–102.CrossRefPubMed
5.
Zurück zum Zitat Bauer A, et al. Evaluation of Hemodynamic and Regional Tissue Perfusion Effects of Minimized Extracorporeal Circulation. J Extracorpor Technol. 2010;42:30–9. Bauer A, et al. Evaluation of Hemodynamic and Regional Tissue Perfusion Effects of Minimized Extracorporeal Circulation. J Extracorpor Technol. 2010;42:30–9.
6.
Zurück zum Zitat van der Laan ME, et al. A hemodynamically significant patent ductus arteriosus does not affect cerebral or renal tissue oxygenation in preterm infants. Neonatology. 2016;110:141–7.CrossRefPubMed van der Laan ME, et al. A hemodynamically significant patent ductus arteriosus does not affect cerebral or renal tissue oxygenation in preterm infants. Neonatology. 2016;110:141–7.CrossRefPubMed
7.
Zurück zum Zitat Chock VY, Rose LA, Mante JV. Near-infrared spectroscopy for detection of a significant patent ductus arteriosus. Pediatr Res. 2016;80:675–80.CrossRefPubMed Chock VY, Rose LA, Mante JV. Near-infrared spectroscopy for detection of a significant patent ductus arteriosus. Pediatr Res. 2016;80:675–80.CrossRefPubMed
8.
Zurück zum Zitat Mintzer JP, Parvez B, Alpan G, LaGamma EF. Effects of sodium bicarbonate correction of metabolic acidosis on regional tissue oxygenation in very low birth weight neonates. J Perinatol. 2015;35:601–6.CrossRefPubMed Mintzer JP, Parvez B, Alpan G, LaGamma EF. Effects of sodium bicarbonate correction of metabolic acidosis on regional tissue oxygenation in very low birth weight neonates. J Perinatol. 2015;35:601–6.CrossRefPubMed
9.
Zurück zum Zitat McNeill S, Gatenby JC, McElroy S, Engelhardt B. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol. 2011;31:51–7.CrossRefPubMed McNeill S, Gatenby JC, McElroy S, Engelhardt B. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol. 2011;31:51–7.CrossRefPubMed
11.
Zurück zum Zitat Carmody JB, Charlton JR. Short-term gestation, long-term risk: prematurity and chronic kidney disease. Pediatrics. 2013;131:1168–79.CrossRefPubMed Carmody JB, Charlton JR. Short-term gestation, long-term risk: prematurity and chronic kidney disease. Pediatrics. 2013;131:1168–79.CrossRefPubMed
12.
Zurück zum Zitat Brenner BM, Diego LG, Sharon A. (1988) Glomeruli and blood pressure: less of one, more the other?. American journal of hypertension 1.4_Pt_1; 335–347. Brenner BM, Diego LG, Sharon A. (1988) Glomeruli and blood pressure: less of one, more the other?. American journal of hypertension 1.4_Pt_1; 335–347.
13.
Zurück zum Zitat Sellmer A, et al. Urinary neutrophil gelatinase-associated lipocalin in the evaluation of patent ductus arteriosus and AKI in very preterm neonates: a cohort study. BMC Pediatr. 2017;17:7.CrossRefPubMedPubMedCentral Sellmer A, et al. Urinary neutrophil gelatinase-associated lipocalin in the evaluation of patent ductus arteriosus and AKI in very preterm neonates: a cohort study. BMC Pediatr. 2017;17:7.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Lin YJ, Chen CM, Rehan VK, Florens A, Wu SY, Kuo YT, et al. Randomized trial to compare renal function and ductal response between indomethacin and ibuprofen treatment in extremely low birth weight infants. Neonatology. 2017;111:195–202.CrossRefPubMed Lin YJ, Chen CM, Rehan VK, Florens A, Wu SY, Kuo YT, et al. Randomized trial to compare renal function and ductal response between indomethacin and ibuprofen treatment in extremely low birth weight infants. Neonatology. 2017;111:195–202.CrossRefPubMed
15.
Zurück zum Zitat Liu P, Capitano B, Stein A, El-Solh AA. (2017) Clinical outcomes of linezolid and vancomycin in patients with nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus stratified by baseline renal function: a retrospective, cohort analysis. BMC nephrology 18.1;1–10. Liu P, Capitano B, Stein A, El-Solh AA. (2017) Clinical outcomes of linezolid and vancomycin in patients with nosocomial pneumonia caused by methicillin-resistant Staphylococcus aureus stratified by baseline renal function: a retrospective, cohort analysis. BMC nephrology 18.1;1–10.
17.
Zurück zum Zitat Selewski DT, et al. Neonatal acute kidney injury. Pediatrics. 2015;136:463–73.CrossRef Selewski DT, et al. Neonatal acute kidney injury. Pediatrics. 2015;136:463–73.CrossRef
18.
Zurück zum Zitat Vidal E, Amigoni A, Brugnolaro V, Ghirardo G, Gamba P, Pettenazzo A, et al. Near-infrared spectroscopy as continuous real-time monitoring for kidney graft perfusion. Pediatr Nephrol. 2014;29:909–14.CrossRefPubMed Vidal E, Amigoni A, Brugnolaro V, Ghirardo G, Gamba P, Pettenazzo A, et al. Near-infrared spectroscopy as continuous real-time monitoring for kidney graft perfusion. Pediatr Nephrol. 2014;29:909–14.CrossRefPubMed
19.
Zurück zum Zitat Choi DK, Kim WJ, Chin JH, Lee EH, Hahm KD, Sim JY, et al. Intraoperative renal regional oxygen desaturation can be a predictor for acute kidney injury after cardiac surgery. J Cardiothorac Vasc Anesth. 2014;28:564–71.CrossRefPubMed Choi DK, Kim WJ, Chin JH, Lee EH, Hahm KD, Sim JY, et al. Intraoperative renal regional oxygen desaturation can be a predictor for acute kidney injury after cardiac surgery. J Cardiothorac Vasc Anesth. 2014;28:564–71.CrossRefPubMed
20.
Zurück zum Zitat Eknoyan G, Lameire N, Eckardt K, Kasiske B, Wheeler D, Levin A, et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;1:5–14. Eknoyan G, Lameire N, Eckardt K, Kasiske B, Wheeler D, Levin A, et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;1:5–14.
21.
Zurück zum Zitat Toyoshima K, et al. Tailor-made circulatory management based on the stress–velocity relationship in preterm infants. J Formos Med Assoc. 2013;112:510–7.CrossRefPubMed Toyoshima K, et al. Tailor-made circulatory management based on the stress–velocity relationship in preterm infants. J Formos Med Assoc. 2013;112:510–7.CrossRefPubMed
22.
Zurück zum Zitat Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A. A Simple Estimate of Glomerular Filtration Rate in Children Derived From Body Length and Plasma Creatinine. Pediatrics. 1976;58:259–63.CrossRefPubMed Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A. A Simple Estimate of Glomerular Filtration Rate in Children Derived From Body Length and Plasma Creatinine. Pediatrics. 1976;58:259–63.CrossRefPubMed
23.
Zurück zum Zitat Levey AS, Coresh J, Bolton K, Culleton B, Harvey KS, Ikizler TA, et al. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:1–266. Levey AS, Coresh J, Bolton K, Culleton B, Harvey KS, Ikizler TA, et al. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39:1–266.
25.
Zurück zum Zitat Schlader ZJ, Rivas E, Soller BR, Convertino VA, Crandall CG. Tissue oxygen saturation during hyperthermic progressive central hypovolemia. Am J Physiology-Regulatory Integr Comp Physiol. 2014;307:731–6.CrossRef Schlader ZJ, Rivas E, Soller BR, Convertino VA, Crandall CG. Tissue oxygen saturation during hyperthermic progressive central hypovolemia. Am J Physiology-Regulatory Integr Comp Physiol. 2014;307:731–6.CrossRef
26.
Zurück zum Zitat Choi DK, et al. Intraoperative renal regional oxygen desaturation can be a predictor for acute kidney injury after cardiac surgery. J Cardiothorac Vasc Anesth. 2014;28:564–71.CrossRefPubMed Choi DK, et al. Intraoperative renal regional oxygen desaturation can be a predictor for acute kidney injury after cardiac surgery. J Cardiothorac Vasc Anesth. 2014;28:564–71.CrossRefPubMed
27.
Zurück zum Zitat Algra SO, Schouten AN, van Oeveren W, van der Tweel I, Schoof PH, Jansen NJG, et al. Low-flow antegrade cerebral perfusion attenuates early renal and intestinal injury during neonatal aortic arch reconstruction. J Thorac Cardiovasc Surg. 2012;144:1323–8.CrossRefPubMed Algra SO, Schouten AN, van Oeveren W, van der Tweel I, Schoof PH, Jansen NJG, et al. Low-flow antegrade cerebral perfusion attenuates early renal and intestinal injury during neonatal aortic arch reconstruction. J Thorac Cardiovasc Surg. 2012;144:1323–8.CrossRefPubMed
28.
Zurück zum Zitat Mintzer JP, Moore JE. Regional tissue oxygenation monitoring in the neonatal intensive care unit: evidence for clinical strategies and future directions. Pediatr Res. 2019;863:296–304.CrossRef Mintzer JP, Moore JE. Regional tissue oxygenation monitoring in the neonatal intensive care unit: evidence for clinical strategies and future directions. Pediatr Res. 2019;863:296–304.CrossRef
29.
Zurück zum Zitat van Bel F, Mintzer JP. Monitoring cerebral oxygenation of the immature brain: a neuroprotective strategy? Pediatr Res. 2018;842:159–64. van Bel F, Mintzer JP. Monitoring cerebral oxygenation of the immature brain: a neuroprotective strategy? Pediatr Res. 2018;842:159–64.
30.
Zurück zum Zitat Kooi EMW, et al. Measuring cerebrovascular autoregulation in preterm infants using near-infrared spectroscopy: an overview of the literature. Expert Rev Neurother. 2017;17:801–18.CrossRefPubMed Kooi EMW, et al. Measuring cerebrovascular autoregulation in preterm infants using near-infrared spectroscopy: an overview of the literature. Expert Rev Neurother. 2017;17:801–18.CrossRefPubMed
31.
Zurück zum Zitat Vieux R, Hascoet JM, Merdariu D, Fresson J, Guillemin F. Glomerular filtration rate reference values in very preterm infants. Pediatrics. 2010;125:1186–92.CrossRef Vieux R, Hascoet JM, Merdariu D, Fresson J, Guillemin F. Glomerular filtration rate reference values in very preterm infants. Pediatrics. 2010;125:1186–92.CrossRef
32.
Zurück zum Zitat Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE. Histomorphometric Analysis of Postnatal Glomerulogenesis in Extremely Preterm Infants. Pediatr Dev Pathol. 2004;7:17–25.CrossRefPubMed Rodríguez MM, Gómez AH, Abitbol CL, Chandar JJ, Duara S, Zilleruelo GE. Histomorphometric Analysis of Postnatal Glomerulogenesis in Extremely Preterm Infants. Pediatr Dev Pathol. 2004;7:17–25.CrossRefPubMed
33.
Zurück zum Zitat Sutherland MR, Gubhaju L, Moore L, Kent AL, Dahlstrom JE, Horne RS, et al. Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol. 2011;22:1365–74.CrossRefPubMedPubMedCentral Sutherland MR, Gubhaju L, Moore L, Kent AL, Dahlstrom JE, Horne RS, et al. Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol. 2011;22:1365–74.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Fanos V, Cataldi L. Renal transport of antibiotics and nephrotoxicity: a review. J Chemother. 2001;13:461–72.CrossRefPubMed Fanos V, Cataldi L. Renal transport of antibiotics and nephrotoxicity: a review. J Chemother. 2001;13:461–72.CrossRefPubMed
36.
Zurück zum Zitat Perazella MA. Drug-induced renal failure: update on new medications and unique mechanisms of nephrotoxicity. Am J Med Sci. 2003;325:349–62.CrossRefPubMed Perazella MA. Drug-induced renal failure: update on new medications and unique mechanisms of nephrotoxicity. Am J Med Sci. 2003;325:349–62.CrossRefPubMed
37.
Zurück zum Zitat Bonsante F, et al. Low renal oxygen saturation at near-infrared spectroscopy on the first day of life is associated with developing acute kidney injury in very preterm infants. Neonatology. 2019;115:198–204.CrossRefPubMed Bonsante F, et al. Low renal oxygen saturation at near-infrared spectroscopy on the first day of life is associated with developing acute kidney injury in very preterm infants. Neonatology. 2019;115:198–204.CrossRefPubMed
Metadaten
Titel
Changes in regional oxygen saturation of the kidney and brain of infants during hospitalization
verfasst von
Daisuke Yoshida, MD
Tomoyuki Shimokaze, MD
Atsushi Kondo, MD
Katsuaki Toyoshima, MD
Tomoko Saito, MD
Publikationsdatum
20.04.2022
Verlag
Springer Netherlands
Erschienen in
Journal of Clinical Monitoring and Computing / Ausgabe 6/2022
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-022-00836-y

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