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Published on: August 19, 2020
Renal Oxygenation (rSO 2 ) Population Parameter Estimates in Premature Infants Routinely Monitored With Near-Infrared
Terri Marin1, Bryan L Williams, Asifhusen Mansuri
1Department of Physiological and Technological Nursing, College of Nursing, Augusta University, Augusta, Georgia (Drs Marin and Williams); Department of Pediatric Nephrology, Medical College of Georgia, Augusta University, Augusta, Georgia (Dr Mansuri); Department of Pediatrics, Division of Neonatology, Medical College of Georgia, Augusta University, Augusta, Georgia (Drs Mundy, Cockfield, Mann, and Stansfield); and Vascular Biology Center, Augusta University, Augusta, Georgia (Dr Stansfield).
Background:
Currently, reference ranges for renal oxygenation measured by near-infrared spectroscopy (NIRS) in preterm infants beyond the first days of life are lacking, especially those born prior to 29 weeks' gestation. Population estimates of renal oxygenation (rSO 2 ) levels among preterm infants over time have yet to be established, leading to reluctance in clinical application.
Purpose:
To characterize the distribution and estimate population parameters for renal oxygenation measured by NIRS during the first 14 days of life among preterm infants.
Methods:
We prospectively observed rSO 2 trends of 37 infants before 34 weeks' gestation and 1800-g or less birth weight for the first 14 days of life. Analyses included distribution fit tests, ordinary least squares (OLS) regression, and t tests.
Results:
Average daily rSO 2 variation steadily increased with 42% difference through the first 14 days of life. For all infants, renal rSO 2 means peaked during the first 3 days of life and plateaued around 7 days. Daily rSO 2 slopes were significantly lower among males and infants 29 weeks' or less gestation.
Implications For Practice:
Renal rSO 2 during the first 14 days of life reflects normal extrauterine transition reaching stabilization around 7 days of life. Gestational age, birth weight, and gender may predict the early trajectory of rSO 2 patterns. Population estimates provide parameters for renal rSO 2 that may indicate early-onset tissue hypoxia when acute or significant drops from baseline occur.
Implications For Research:
We present a framework to guide future research using renal NIRS technology in preterm infants to determine deviations from expected trends that may precede renal injury.
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