Liver Regional Oxygen Saturation in Preterm Infants with Patent Ductus Arteriosus Status.

Background/

Objectives

Near-infrared spectroscopy measures regional oxygen saturation (RSO2) in target tissues. Cerebral and renal RSO2 are associated with hemodynamically significant patent ductus arteriosus (PDA) in preterm infants. The aim of this study was to determine whether liver RSO2 is associated with PDA status.

Methods

Preterm infants born before 32 weeks of gestation and/or weighing <1.5 kg were enrolled. Cerebral, renal, and liver RSO2 values were recorded on day 2 (D2; 48-72 h), day 7 (D7; 7 ± 2 days), and day 14 (D14; 14 ± 3 days), along with the corresponding point-of-care echocardiographic findings.

Results

Of the forty preterm infants enrolled (mean ± SD gestational age, 28.8 ± 2.2 weeks; birthweight, 1209.9 ± 364.2 g), 22 (55.0%) had spontaneous PDA closure, 18 (45.0%) underwent pharmacological closure, and 4 (10.0%) required surgical closure. Cerebral, renal, and liver RSO2 values were significantly lower in infants with PDA than those without. Liver RSO2 was significantly lower in the presence of PDA at D7 (68.19 ± 13.24 vs. 82.14 ± 5.58, p < 0.001) and D14 (59.33 ± 12.06 vs. 80.0 ± 6.48, p < 0.001). Liver RSO2 showed a strong inverse association with a higher LA/Ao ratio (β -38.71, 95%CI -55.03 to -22.40, p <0.001) in the linear mixed model analysis.

Conclusions

Liver RSO2 was associated with different PDA statuses. Future studies exploring the potential utility of liver RSO2 as an adjunct parameter for detecting and guiding the management of hemodynamically significant PDA in preterm infants may be warranted.