Abstract
Introduction
This study aims to compare cerebral and splanchnic regional oxygen
saturation(rSO2) in premature infants with duct-dependent congenital heart
disease (CHD) using near-infrared spectroscopy (NIRS) with that of
case-control premature infants without CHD.
Materials and Methods
Premature infants with duct-dependent CHD
requiring prostaglandin E1 (PGE1) for more than 10 days and control
preterm infants (without CHD) were monitored for 36 hours using NIRS to
assess cerebral and splanchnic rSO2. Both groups received gavage enteral
feeding. Multiple measurements were taken around feeding at three
different times (30 minutes before, during, and 30 minutes after
feeding).
Results
A total of 16 cases were included in the study (8 CHD and 8 controls). The
CHD infants had the following diagnoses: four with aortic coarctation, two
with interrupted aortic arch, one with hypoplastic left heart syndrome, and
one with D-transposition of the great arteries. The median gestational age
(35 weeks in duct-dependent CHD vs. 34 weeks in controls) and birth weight
(1850 g vs. 1800 g, respectively) were similar between the two groups
(p>0.05). The median cerebral NIRS measurements in the controls were 12
points higher than in the cases (P=0.03), and the splanchnic NIRS
measurements were 20 points higher (P=0.01). The median cerebral NIRS
measurements in the cases were 60%, 64%, and 62% at baseline, during
feeding, and post-feeding, respectively, while the controls had values of
72%, 74%, and 71% at the same times. The median splanchnic NIRS measurements
in the cases were 30%, 35%, and 38% at baseline, during feeding, and
post-feeding, respectively, while the controls had values of 50%, 52%, and
54%. Similar changes in cerebral and splanchnic NIRS values were observed
during feeding in both the cases and controls (p>0.05).
Conclusion
Premature neonates with duct-dependent CHD have a reduction in both cerebral
and splanchnic rSO2 values when compared to age-matched controls. NIRS
monitoring demonstrated lower regional oxygen saturation levels in
duct-dependent CHD infants compared with controls, suggesting reduced tissue
oxygenation during feeding. Further studies with larger sample sizes are
needed in this area.
Keywords
premature - congenital heart disease - cerebral oxygenation - splanchnic oxygenation
