Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
Pediatr Res. 2022 Dec;92(6):1744-1748. doi: 10.1038/s41390-022-02036-5. Epub 2022 Mar 30.
To describe renal regional saturation of oxygen (RrSO) values during the first week of life for preterm neonates born at <32 weeks gestational age (GA).
RrSO values recorded over the first week of life using near-infrared spectroscopy were retrospectively analyzed in this two-center cohort study of preterm infants without known congenital anomalies of the kidney.
A cohort of 109 neonates with a median GA of 26.9 weeks and a median of 120 (IQR: 87-141) hours of continuous RrSO monitoring were included. Separately fitted trends in RrSO did not differ (p = 0.52) between sites and demonstrated a consistent decrease in RrSO by 20 points (95% CI: 9.6-30.1) during the first 60 h of life, followed by a stabilization of RrSO thereafter. RrSO baseline trends increased by 2.1 (95% CI: 0.8-3.3) percentage points for each additional week GA between 24 and 32 weeks GA.
Despite differences in adjusted RrSO values between sites, profiles over time are consistent, allowing for the determination of RrSO trajectories in preterm infants. This expected pattern of RrSO changes in the first week may help guide future investigations and interventions to identify and reduce kidney injury in the preterm neonate.
Renal regional saturation of oxygen (RrSO) slowly decreases during the first 60 h of age in <32-week preterm neonates. While site differences were identified with respect to absolute values, RrSO trends from two different centers were not different. Lower gestational age neonates have lower RrSO levels during the first week.
描述胎龄<32 周的早产儿在生命的第一周肾区氧饱和度(RrSO)值。
本研究为回顾性两中心队列研究,纳入了无先天性肾畸形的早产儿,使用近红外光谱仪记录了生命第一周的 RrSO 值。
本研究纳入了 109 例胎龄中位数为 26.9 周、中位数为 120 小时(IQR:87-141)连续 RrSO 监测的新生儿。单独拟合的 RrSO 趋势在两个中心之间没有差异(p=0.52),并显示 RrSO 在生命最初 60 小时内以 20 个点(95%CI:9.6-30.1)持续下降,此后 RrSO 稳定。胎龄在 24 至 32 周之间每增加一周,RrSO 基线趋势增加 2.1(95%CI:0.8-3.3)个百分点。
尽管两个中心的调整后 RrSO 值存在差异,但随时间变化的 RrSO 模式是一致的,这使得确定早产儿的 RrSO 轨迹成为可能。在生命的第一周,这种预期的 RrSO 变化模式可能有助于指导未来的研究和干预,以识别和减少早产儿的肾损伤。
胎龄<32 周的早产儿在生命的前 60 小时内,RrSO 缓慢下降。尽管在绝对值方面存在着中心间的差异,但两个中心的 RrSO 趋势并无差异。胎龄较低的新生儿在第一周的 RrSO 水平较低。