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Renal Oxygenation (rSO2) Population Parameter Estimates in Premature Infants Routinely Monitored With Near-Infrared Spectroscopy
Advances in Neonatal Care ( IF 1.7 ) Pub Date : 2022-08-01 , DOI: 10.1097/anc.0000000000000927
Terri Marin 1 , Bryan L Williams , Asifhusen Mansuri , Cynthia Mundy , Christy Cockfield , Paul C Mann , Brian K Stansfield
Affiliation  

Background: 

Currently, reference ranges for renal oxygenation measured by near-infrared spectroscopy (NIRS) in preterm infants beyond the first days of life are lacking, especially those born prior to 29 weeks' gestation. Population estimates of renal oxygenation (rSO2) levels among preterm infants over time have yet to be established, leading to reluctance in clinical application.

Purpose: 

To characterize the distribution and estimate population parameters for renal oxygenation measured by NIRS during the first 14 days of life among preterm infants.

Methods: 

We prospectively observed rSO2 trends of 37 infants before 34 weeks' gestation and 1800-g or less birth weight for the first 14 days of life. Analyses included distribution fit tests, ordinary least squares (OLS) regression, and t tests.

Results: 

Average daily rSO2 variation steadily increased with 42% difference through the first 14 days of life. For all infants, renal rSO2 means peaked during the first 3 days of life and plateaued around 7 days. Daily rSO2 slopes were significantly lower among males and infants 29 weeks' or less gestation.

Implications for Practice: 

Renal rSO2 during the first 14 days of life reflects normal extrauterine transition reaching stabilization around 7 days of life. Gestational age, birth weight, and gender may predict the early trajectory of rSO2 patterns. Population estimates provide parameters for renal rSO2 that may indicate early-onset tissue hypoxia when acute or significant drops from baseline occur.

Implications for Research: 

We present a framework to guide future research using renal NIRS technology in preterm infants to determine deviations from expected trends that may precede renal injury.



中文翻译:

使用近红外光谱常规监测的早产儿肾氧合 (rSO2) 群体参数估计

背景: 

目前,尚缺乏通过近红外光谱 (NIRS) 测量出生后第一天的早产儿肾氧合参考范围,尤其是妊娠 29 周之前出生的早产儿。随着时间的推移,早产儿肾氧合(rSO 2 )水平的群体估计尚未确定,导致临床应用上的犹豫。

目的: 

旨在描述早产儿出生后 14 天内通过 NIRS 测量的肾氧合分布并估计群体参数。

方法: 

我们前瞻性地观察了37 名妊娠 34 周前且出生体重 1800 克或以下的婴儿在生命前 14 天的rSO 2趋势。分析包括分布拟合检验、普通最小二乘法 (OLS) 回归和t检验。

结果: 

出生后前 14 天,每日平均 rSO 2变化稳步增加,差异达 42%。对于所有婴儿,肾 rSO 2平均值在出生后的前 3 天达到峰值,并在 7 天左右达到稳定水平。男性和妊娠 29 周或以下的婴儿的每日 rSO 2斜率显着较低。

对实践的启示: 

出生后前 14 天的肾 rSO 2反映了正常的宫外过渡,在出生后 7 天左右达到稳定。胎龄、出生体重和性别可以预测 rSO 2模式的早期轨迹。群体估计提供了肾脏 rSO 2的参数,当发生从基线急剧或显着下降时,该参数可能表明早发组织缺氧。

对研究的影响: 

我们提出了一个框架来指导未来在早产儿中使用肾脏近红外光谱技术的研究,以确定肾损伤之前可能出现的与预期趋势的偏差。

更新日期:2022-08-01
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