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Changes in regional oxygen saturation of the kidney and brain of infants during hospitalization

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Abstract

Background

In pre-term infants, the postnatal changes in the regional oxygen saturation (rSO2) of the brain and kidney are unclear.

Methods

We performed a prospective observational study. We measured the cerebral/renal rSO2 ratio and recorded the associated clinical features of infants born at 23 to 41 weeks of gestation weekly from the early postnatal period to discharge.

Results

The median cerebral/renal rSO2 ratios (interquartile ranges) between birth and the expected date of birth were 1.13 (1.06–1.26) at 23–24 weeks (n = 7), 1.18 (1.10–1.32) at 25–26 weeks (n = 11), 1.24 (1.11–1.37) at 27–28 weeks (n = 9), 1.12 (1.05–1.19) at 29–30 weeks (n = 4), 1.11 (1.03–1.15) at 31–32 weeks (n = 5), 1.02 (0.98–1.06) at 33–34 weeks (n = 9), 0.98 (0.94–1.06) at 35–36 weeks (n = 19), and 0.95 (0.86–0.99) at 37–41 weeks of gestation (n = 22). The median cerebral/renal rSO2 ratio did not significantly change after birth, but with increasing gestational age, the cerebral/renal rSO2 ratio at the expected date of birth decreased (r = − 0.74, p < 0.001). Nephrotoxic drugs did not affect cerebral/renal rSO2 at the expected date of birth, after adjustment for clinical factors.

Conclusions

Unlike in most infants born after the late pre-term period, the renal rSO2 remained lower than the cerebral rSO2 on the expected date of birth in infants born very pre-term.

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Abbreviations

rSO2 :

Regional oxygen saturation

CKD:

chronic kidney disease

PDA:

patent ductus arteriosus

SpO2 :

pulse oximetric saturation

IQR:

interquartile range

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Acknowledgements

We thank Mark Cleasby, PhD from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Neonatology, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, 232-8555, Yokohama, Japan

    Daisuke Yoshida MD, Tomoyuki Shimokaze MD, Atsushi Kondo MD, Katsuaki Toyoshima MD & Tomoko Saito MD

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  1. Daisuke Yoshida MD
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  2. Tomoyuki Shimokaze MD
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  3. Atsushi Kondo MD
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  4. Katsuaki Toyoshima MD
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Contributions

Daisuke Yoshida: Conceptualization, Original draft preparation. Tomoyuki Shimokaze: Writing- Reviewing and Editing. Tomoko Saito: Data curation, Investigation. Katsuaki Toyoshima, Atsushi Kondo: Supervision.

Statement of financial support

There was no relevant funding for this study.

Disclosure statement

The authors declare no conflicts of interest.

Corresponding author

Correspondence to Daisuke Yoshida MD.

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Statement of financial support

There was no relevant funding for this study.

Consent Statement

Written consent to participate in the study was obtained from the parents of the infants whose rSO2 was measured in the maternity ward for the study. We routinely measured rSO2 for clinical management purposes in infants admitted to the Neonatal Intensive Care Unit (NICU). Infants admitted to the NICU were not required to give informed consent for their participation in the study because the analysis used anonymized clinical data that were obtained after the guardian of each patient agreed to treatment by providing their written consent. We also adopted an opt-out system and posted a summary of the study on the hospital’s website (http://kcmc.kanagawa-pho.jp/about/ethics_research.html).

Ethics approval

The study was conducted in accordance with the principles contained within the Declaration of Helsinki and approved by the institutional review board of Kanagawa Children’s Medical Center (No. 1807-7, 2019).

Consent to participate

All the authors were responsible for diagnosis and the treatment of the patients. All the authors have read and approved the final version of the manuscript.

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Yoshida, D., Shimokaze, T., Kondo, A. et al. Changes in regional oxygen saturation of the kidney and brain of infants during hospitalization. J Clin Monit Comput 36, 1859–1867 (2022). https://doi.org/10.1007/s10877-022-00836-y

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  • DOI: https://doi.org/10.1007/s10877-022-00836-y

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