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对于患有左侧梗阻性病变的足月儿或近足月儿,无论升主动脉还是降主动脉存在逆行血流,脑和肾的氧饱和度均未受损。

Cerebral and Renal Oxygen Saturation Are Not Compromised in the Presence of Retrograde Blood Flow in either the Ascending or Descending Aorta in Term or Near-Term Infants with Left-Sided Obstructive Lesions.

作者信息

van der Laan Michelle E, Mebius Mirthe J, Roofthooft Marcus T R, Bos Arend F, Berger Rolf M F, Kooi Elisabeth M W

机构信息

Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

出版信息

Neonatology. 2017;112(3):217-224. doi: 10.1159/000473870. Epub 2017 Jul 14.

Abstract

BACKGROUND

In infants with left-sided obstructive lesions (LSOL), the presence of retrograde blood flow in either the ascending or descending aorta may lead to diminished cerebral and renal blood flow, respectively.

OBJECTIVES

Our aim was to compare cerebral and renal tissue oxygen saturation (rSO2) between infants with LSOL with antegrade and retrograde blood flow in the ascending aorta and with and without diastolic backflow in the descending aorta.

METHODS

Based on 2 echocardiograms, the study group was categorized according to the direction of blood flow in the ascending and descending aorta. We measured cerebral and renal rSO2 using near-infrared spectroscopy and calculated fractional tissue oxygen extraction (FTOE).

RESULTS

Nineteen infants with LSOL, admitted to the NICU between 0 and 28 days after birth, were included. Infants with antegrade blood flow (n = 12) and infants with retrograde blood flow in the ascending aorta (n = 7) had similar cerebral rSO2 and FTOE during both echocardiograms. Only during the first echocardiogram, infants with retrograde blood flow in the ascending aorta had lower renal FTOE (0.14 vs. 0.32, p = 0.04) and tended to have higher renal rSO2 (80 vs. 65%, p = 0.09). The presence of diastolic backflow in the descending aorta was not associated with cerebral or renal rSO2 and FTOE during the first (n = 8) as well as the second echocardiogram (n = 10).

CONCLUSIONS

Retrograde blood flow in the ascending aorta was not associated with cerebral oxygenation, while diastolic backflow in the descending aorta was not associated with renal oxygenation in infants with LSOL.

摘要

背景

在患有左侧梗阻性病变(LSOL)的婴儿中,升主动脉或降主动脉出现逆行血流可能分别导致脑血流和肾血流减少。

目的

我们的目的是比较升主动脉有顺行和逆行血流以及降主动脉有和没有舒张期反流的LSOL婴儿的脑和肾组织氧饱和度(rSO2)。

方法

根据2次超声心动图,研究组根据升主动脉和降主动脉的血流方向进行分类。我们使用近红外光谱法测量脑和肾的rSO2,并计算组织氧摄取分数(FTOE)。

结果

纳入了19例出生后0至28天入住新生儿重症监护病房(NICU)的LSOL婴儿。升主动脉有顺行血流的婴儿(n = 12)和升主动脉有逆行血流的婴儿(n = 7)在两次超声心动图检查期间的脑rSO2和FTOE相似。仅在第一次超声心动图检查期间,升主动脉有逆行血流的婴儿的肾FTOE较低(0.14对0.32,p = 0.04),并且肾rSO2有升高趋势(80%对65%,p = 0.09)。降主动脉舒张期反流的存在与第一次(n = 8)和第二次超声心动图检查(n = 10)期间的脑或肾rSO2及FTOE均无关。

结论

在患有LSOL的婴儿中,升主动脉的逆行血流与脑氧合无关,而降主动脉的舒张期反流与肾氧合无关。

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