Influence of ductus arteriosus on peripheral muscle oxygenation and perfusion in neonates

Abstract

Objective: In neonates, a patent ductus arteriosus (DA) may be associated with severe complications. We used near-infrared spectroscopy (NIRS) with venous occlusion to investigate the influence of an open DA on peripheral muscle oxygenation/perfusion in preterm neonates.

Approach: We analyzed secondary outcome parameters collected as part of prospective observational studies. NIRS measurements were performed between the first and third day of life. Arterial oxygen saturation (SaO₂) and heart rate (HR) were monitored by pulse oximetry on the ipsilateral foot. Venous occlusion was performed with a blood pressure cuff on the thigh. Tissue oxygenation index (TOI), hemoglobin flow (Hbflow), oxygen delivery (DO₂), oxygen consumption (VO₂), mixed venous oxygenation (SvO₂), and fractional oxygen extraction (FOE) were assessed. Echocardiography was performed within plus/minus 6 h from NIRS measurements.

Main results: Twenty-eight neonates were included. In neonates with open DA (n = 15), the FOE was significantly higher (p = 0.046). DA diameter correlated negatively with SvO₂ (r = -0.413, p = 0.032) and positively with FOE (r = 0.417, p = 0.030). In neonates with open DA, SaO₂ was significantly lower (p = 0.041). DA diameter correlated negatively with SaO₂ (r = -0.377, p = 0.048) and positively with HR (r = 0.489, p = 0.010).

Significance: Our results showed that an open DA influences peripheral muscle oxygenation in preterm neonates.