Arman Didem, Sancak Selim, Gürsoy Tugba, Topcuoğlu Sevilay, Karatekin Güner, Ovalı Fahri
Department of Neonatal Intensive Care, Zeynep Kamil Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
Department of Neonatology, School of Medicine, Koc University, Istanbul, Turkey.
J Matern Fetal Neonatal Med. 2020 Apr;33(7):1245-1252. doi: 10.1080/14767058.2019.1639661. Epub 2019 Jul 15.
To determine if near-infrared spectroscopy (NIRS), which is easier to obtain than Doppler ultrasonography (USG), may be used in accordance with Doppler USG to provide additional data for assessment of organ blood flow velocities in preterm infants with hemodynamically significant PDA. Thirty-one infants who were treated with ibuprofen for closure of PDA were monitored continuously with NIRS. Cerebral, mesenteric, and renal arterial blood flow velocities were measured with Doppler USG before and after the treatment. While cerebral, mesenteric, and renal fractional oxygen extraction (FTOE) measurements decreased significantly ( = .042, < .001, < .001, respectively), NIRS measurements ( = .016, < .001, < .001, respectively) and mean blood flow velocities ( = .003, = .011, = .002, respectively) increased significantly after the treatment. There was a significant correlation between pretreatment cerebral and mesenteric FTOE and resistive index (RI) values ( = 0.45, = .01, and = 0.46, = .01, respectively). However, no correlation was observed between renal FTOE values and renal RI ( = 0.33, = .06). Posttreatment cerebral, renal, and mesenteric FTOE values correlated positively with corresponding RI ( = 0.41, = .02; = 0.39, = .02; = 0.65, < 01; respectively). Pretreatment and posttreatment cerebral, mesenteric, and renal FTOE values and arterial mean velocities were inversely correlated (pretreatment: = 0.69, < .01; = 0.72, < .01; = 0.77, < .01; posttreatment: = 0.54, = .01; = 0.69, < .01; = 0.38, = .01; respectively). As Doppler and NIRS measurements correlated significantly, we concluded that NIRS might be used in monitoring organ blood flow in preterm infants with PDA, which may provide additional data for management of this condition.
为了确定相较于多普勒超声检查（USG）更易获取的近红外光谱技术（NIRS）是否可与多普勒超声检查配合使用，为评估患有血流动力学显著动脉导管未闭（PDA）的早产儿的器官血流速度提供额外数据。对31例使用布洛芬治疗动脉导管未闭的婴儿进行了近红外光谱技术连续监测。在治疗前后用多普勒超声检查测量脑、肠系膜和肾动脉血流速度。虽然脑、肠系膜和肾的氧摄取分数（FTOE）测量值显著下降（分别为P = 0.042、P < 0.001、P < 0.001），但治疗后近红外光谱技术测量值（分别为P = 0.016、P < 0.001、P < 0.001）和平均血流速度（分别为P = 0.003、P = 0.011、P = 0.002）显著增加。治疗前脑和肠系膜的FTOE与阻力指数（RI）值之间存在显著相关性（分别为r = 0.45，P = 0.01和r = 0.46，P = 0.01）。然而，未观察到肾FTOE值与肾RI之间的相关性（r = 0.33，P = 0.06）。治疗后脑、肾和肠系膜的FTOE值与相应的RI呈正相关（分别为r = 0.41，P = 0.02；r = 0.39，P = 0.02；r = 0.65，P < 0.01）。治疗前和治疗后脑、肠系膜和肾的FTOE值与动脉平均速度呈负相关（治疗前：r = 0.69，P < 0.01；r = 0.72，P < 0.01；r = 0.77，P < 0.01；治疗后：r = 0.54，P = 0.01；r = 0.69，P < 0.01；r = 0.38，P = 0.01）。由于多普勒和近红外光谱技术测量值显著相关，我们得出结论，近红外光谱技术可用于监测患有动脉导管未闭的早产儿的器官血流，这可能为这种情况的管理提供额外数据。
