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

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.

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.

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).

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