Harer Matthew W, Gadek Lauren, Rothwell Amy C, Richard Luke, Starr Michelle C, Adegboro Claudette O
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Division of Neonatology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Am J Perinatol. 2024 May;41(S 01):e1228-e1234. doi: 10.1055/s-0043-1761296. Epub 2023 Jan 29.
The aim of the study is to assess the correlation of renal regional tissue saturation of oxygen (RrSO) measured by near-infrared spectroscopy (NIRS) in preterm neonates to venous oxygen saturation (SvO) obtained from umbilical venous catheters (UVCs), arterial oxygen saturation (SaO) obtained from umbilical artery catheters (UACs), and capillary oxygen saturation (ScO) from capillary heel blood draws.
A secondary analysis of a prospective RrSO monitoring study in preterm neonates born <32 weeks gestational age. Neonates with any blood gas obtained during RrSO monitoring were included. RrSO was compared with simultaneous O saturation using non-parametric Mann Whitney U-test and Spearman correlation coefficient.
In 35 neonates, 25 UVC, 151 UAC, and 68 heel capillary specimens were obtained. RrSO was lower than the median SvO (58.8 vs. 78.9, <0.01), SaO (51.0 vs. 93.2, <0.01), and ScO (62.2 vs. 94.25, <0.01). RrSO values correlated to both SaO and ScO ( = 0.32; <0.01, = 0.26; = 0.03), but not SvO ( = 0.07; = 0.74).
In this secondary analysis, RrSO was consistently lower than blood gas O saturations and correlated with SaO and ScO but not SvO. Lack of a correlation to SvO could be due to the small UVC sample size limiting statistical power. Future studies should prospectively evaluate if RrSO truly primarily reflects venous oxygenation in preterm neonates.
· Renal oxygenation correlates with arterial and capillary oxygen saturation.. · Renal oxygenation did not correlate with venous oxygenation from umbilical venous catheters.. · Studies are needed to determine if renal oxygenation primarily reflects venous or arterial oxygen..
本研究旨在评估通过近红外光谱法（NIRS）测量的早产儿肾脏局部组织氧饱和度（RrSO）与通过脐静脉导管（UVC）获得的静脉血氧饱和度（SvO）、通过脐动脉导管（UAC）获得的动脉血氧饱和度（SaO）以及足跟毛细血管血样的毛细血管血氧饱和度（ScO）之间的相关性。
对孕周小于32周的早产儿进行的一项前瞻性RrSO监测研究的二次分析。纳入在RrSO监测期间获得任何血气结果的新生儿。使用非参数曼-惠特尼U检验和斯皮尔曼相关系数将RrSO与同时测量的血氧饱和度进行比较。
在35例新生儿中，获得了25份UVC样本、151份UAC样本和68份足跟毛细血管样本。RrSO低于SvO中位数（58.8对78.9，P<0.01）、SaO中位数（51.0对93.2，P<0.01）和ScO中位数（62.2对94.25，P<0.01）。RrSO值与SaO和ScO均相关（r = 0.32；P<0.01，r = 0.26；P = 0.03），但与SvO不相关（r = 0.07；P = 0.74）。
在这项二次分析中，RrSO始终低于血气血氧饱和度，且与SaO和ScO相关，但与SvO不相关。与SvO缺乏相关性可能是由于UVC样本量小限制了统计效力。未来的研究应前瞻性地评估RrSO是否真的主要反映早产儿的静脉氧合情况。
· 肾脏氧合与动脉血氧饱和度和毛细血管血氧饱和度相关。· 肾脏氧合与脐静脉导管的静脉氧合不相关。· 需要进行研究以确定肾脏氧合主要反映的是静脉氧还是动脉氧。
