Effects of surfactant therapy, ventilation, and patent ductus arteriosus on regional pulmonary and cerebral oxygenation in preterm infants using near-infrared spectroscopy.

BACKGROUND

Near-infrared spectroscopy (NIRS) is widely used to assess cerebral oxygenation, its role in evaluating regional pulmonary oxygenation in preterm infants remains underexplored.

OBJECTIVE

Evaluate regional pulmonary oxygen saturation (rpSO₂) relative to regional cerebral oxygenation (rcSO₂) using NIRS and examine the effects of surfactant administration and hemodynamically significant patent ductus arteriosus (hsPDA).

METHODS

Thirty preterm infants underwent 12-h rpSO₂ and rcSO₂ monitoring. Surfactant effects were assessed with pre- and post-administration rpSO₂ values. Fractional Oxygen Extraction (FOE) and SpO₂/FiO₂ (S/F) ratio were calculated.

RESULTS

Mean rcSO₂ was higher and less variable than rpSO₂ values (78% vs. 72%, p < 0.01). Right lung rpSO₂ exceeded left (74% vs. 71%, p < 0.01), especially in infants with hsPDA. Surfactant increased rpSO₂ bilaterally (p < 0.01), with greater increase in the right lung. rpSO₂ correlated strongly with the S/F ratio (r = 0.83, p < 0.01).

CONCLUSIONS

Regional differences of rpSO₂ and FOE were observed, particularly in the setting of hsPDA and after surfactant therapy.