STATE INSTITUTION «DNIPROPETROVSK MEDICAL ACADEMY OF THE MINISTRY OF HEALTH OF UKRAINE» (SI «DMA»), DNIPRO, UKRAINE.
REGIONAL CHILDREN'S CLINICAL HOSPITAL, DNIPRO, UKRAINE.
Wiad Lek. 2021;74(10 pt 1):2379-2383.
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.
研究伴有 HSPDA 的早产儿肾脏的氧合状态（RrSO2）和组织氧摄取分数（FTOE）。
材料和方法：将 74 例早产儿（胎龄 29-36 周）分为三组：I 组-40 例 HSPDA 患儿，II 组-17 例无血流动力学障碍的动脉导管未闭（PDA）患儿，III 组-17 例动脉导管关闭患儿。在出生后的第 1、3 和 10 天，使用近红外光谱全天评估肾脏氧饱和度（RrSO2）。根据公式 FTOE =（SpO2-RrSO2）/SpO2 计算 FTOE。
结果：在 HSPDA 患儿的第 1 和第 3 天，与无血流动力学障碍的 PDA 患儿和动脉导管关闭的患儿相比，肾脏组织的 RrSO2 显著降低，FTOE 显著增加。这些结果可以用“全身循环盗血”现象和低灌注、肾组织缺血的发展来解释，这导致了实质内对氧气的需求增加。在第 10 天，第一天患有 HSPDA 的早产儿的 RrSO2 增加，FTOE 减少。
结论：使用可以作为一种筛选工具，非侵入性监测肾脏氧合情况，以识别 HSPDA 中的“盗管”现象。
