Deniz İNCE ANUK, Ayşe ECEVİT, Mahmut GÖKDEMİR, Aylin TARCAN, Ece YAPAKÇI, Hande GÜLCAN, M. Agah TEKİNDAL

Inferior Vena Cava Oxygen Saturation during the First Three Postnatal Days in Preterm Newborns with and without Patent Ductus Arteriosus

Background: Inferior vena cava (IVC) oxygen saturation as an indicator of mixed venous oxygenation may be valuable for understanding postnatal adaptations in newborn infants. It is unknown how this parameter progresses in critically ill premature infants. Aims: To investigate IVC oxygen saturation during the first three days of life in preterm infants with and without patent ductus arteriosus (PDA). Study Design: Case-control study. Methods: Twenty-seven preterm infants were admitted to the Neonatal Intensive Care. Preterm infants with umbilical venous catheterization were included in the study. Six umbilical venous blood gas values were obtained from each infant during the first 72 hours of life. Preterm infants in the study were divided into two groups. Haemodynamically significant PDA was diagnosed by echocardiography in 11 (41%) infants before the 72nd hour of life in the study group and ibuprofen treatment was started, whereas 16 (59%) infants who didn't have haemodynamically significant PDA were included in the control group. Results: In the entire group, the highest value of mean IVC oxygen saturation was 79.9% at the first measurement and the lowest was 64.8% at the 72nd hour. Inferior vena cava oxygen saturations were significantly different between the study and control groups. Posthoc analysis revealed that the first and 36th hour measurements made the difference (p=0.01). Conclusion: Inferior vena cava oxygen saturation was found to be significantly different between preterm infants with and without PDA. Further studies are needed to understand the effect of foetal shunts on venous oxygenation during postnatal adaptation in newborn infants.

PDF

___

Whyte RK. Mixed venous oxygen saturation in the newborn. Can we and should we measure it? Scand J Clin Lab Invest Suppl 1990;203:203-11. [CrossRef]
Van der Hoeven MA, Maertzdorf WJ, Blanco CE. Continuous cen- tral venous oxygen saturation (ScvO2) measurement using a fiber optic catheter in newborn infants. Arch Dis Child Fetal Neonatal Ed 1996;74:177-81. [CrossRef]
Plotz FB, van Lingen RA, Bos AP. Venous oxygen measurements in the inferior vena cava in neonates with respiratory failure. Crit Care 1998;2:57-60. [CrossRef]
Hart J, Vemgal P, Cocks-Drew S, Harrison C, Andersen C. The relation between inferior vena cava oxygen saturation, superior vena cava flow, fractional oxygen extraction and haemoglobin affinity in sick newborns: A pilot study. Acta Paediatr 2006;95:50-5. [CrossRef]
O'Connor TA, Hall RT. Mixed venous oxygenation in critically ill neo- nates. Crit Care Med 1994;22:343-6. [CrossRef]
Dudell G, Cornish JD, Bartlett RH. What constitutes adequate oxygen- ation? Pediatrics 1990;85:39-41.
Hirschl RB, Palmer P, Heiss KF, Hultquist K, Fazzalari F, Bartlett RH. Evaluation of the right atrial venous oxygen saturation as a physiologic monitor in a neonatal model. J Pediatr Surg 1993;28:901-5. [CrossRef]
van der Hoeven MA, Maertzdorf WJ, Blanco CE. Feasibility and accu- racy of fiberobtic catheter for measurement of venous oxygen saturation in newborn infants. Acta Paediatr 1995;84:122-7. [CrossRef]
van der Hoeven MA, Maertzdorf WJ, Blanco CE. Mixed venous oxygen saturation and biochemical parameters of hypoxia during progressive hypoxemia in 10- to 14-day-old piglets. Pediatr Res 1997;42:878-84. [CrossRef]
van der Hoeven MA, Maertzdorf WJ, Blanco CE. Relationship between mixed venous oxygen saturation and markers of tissue oxygenation in progressive hypoxic hypoxia and in isovolemic anemic hypoxia in 8- to 12-day-old piglets. Crit Care Med 1999;27:1885-92. [CrossRef]
Edwards JD. Oxygen transport in cardiogenic and septic shock. Crit Care Med 1991;19:658-63. [CrossRef]
MacDonald MG, Chou MM. Preventing complications from lines and tubes. Semin Perinatol 1986;10:224-33.
Martin J, Shekerdemian LS. The monitoring of venous saturations of oxygen in children with congenitally malformed hearts. Cardiol Young 2009;19:34-9. [CrossRef]
Goodrich C. Continuous central venous oximetry monitoring. Crit Care Nurs Clin North Am 2006;18:203-9. [CrossRef]
Liakopoulos OJ, Ho JK, Yezbick A, Sanchez E, Naddell C, Buckberg GD, et al. An experimental and clinical evaluation of a novel central ve- nous catheter with integrated oximetry for pediatric patients undergoing cardiac surgery. Anesth Analg 2007;105:1598-604. [CrossRef]
Kissoon N, Spenceley N, Krahn G, Milner R. Continuous central venous oxygen saturation monitoring under varying physiological conditions in an animal model. Anaesth Intensive Care 2010;38:883-9.
Yapakçı E, Ecevit A, Törer B, Ince DA, Gökdemir M, Gülcan H, et al. "Shunt index" can be used to predict clinically significant patent ductus arteriosus in premature neonates in early post-natal life. Cardiol Young 2013;2:1-5.