CONDITION OF RENAL OXYGENATION IN PRETERM INFANTS WITH HEMODINAMICALLY SIGNIFICANT PATENT DUCTUS ARTERIOSUS

Abstract

The aim: To study the condition of renal oxygenation (RrSO2) and fractional tissue oxygen extraction (FTOE) in the kidneys of premature infants with HSPDA. Materials and methods: 74 preterm newborns (gestational age 29-36 weeks) were divided into three groups: І – 40 children with HSPDA, ІІ – 17 children with patent ductus arteriosus (PDA) without hemodynamic disorders, ІІІ – 17 children with closed ductus arteriosus. Renal oxygen saturation (RrSO2) was assessed during the whole day on the first, third and tenth day of life with near-infrared spectroscopy. FTOE was calculated according to the formula: FTOE = (SpO2 – RrSO2)/SpO2. Results: With HSPDA on the first and third days of life, there was a significant decrease in RrSO2 and a significant increase in FTOE by the kidney tissue in comparison with children with PDA without hemodynamic disorders and children with a closed ductus arteriosus. The results obtained can be explained by the “phenomenon of the systemic circulation stealing” and the development of hypoperfusion, ischemia of the kidney tissues, which leads to an increase in the need for oxygen in the parenchyma.On the tenth day of life, premature infants who had HSPDA on the first day showed an increase in RrSO2 and a decrease in FTOE. Conclusions: Non-invasive monitoring of renal oxygenation using can be used as a screening tool to identify the phenomenon of “ductal stealing” in HSPDA.