Renal and mesenteric tissue oxygenation in preterm infants treated with oral ibuprofen

Abstract Background: Hemodynamically significant patent ductus arteriosus (PDA) is a common problem in preterm infants which often causes significant morbidities. Although PDA induces alterations in various tissue perfusion, there is scarce information about the effect of oral ibuprofen on hemodynamics of regional tissues. Objective: To investigate, using near-infrared spectroscopy, the effect of oral ibuprofen on renal and mesenteric tissue oxygenation and oxygen extraction in preterm infants with a diagnosis of hemodynamically significant PDA. Patients and methods: Fifteen infants (gestational age <32 weeks) with the diagnosis of hemodynamically significant PDA treated with oral ibuprofen were monitored for near-infrared spectroscopy – determined renal and mesenteric oxygenation. The infants with PDA were matched for gestational age, postnatal age with infants without PDA, who served as control subjects. Results: In infants with PDA, mean arterial blood pressure was significantly lower compared with the control infants [39.3 (range:36–54) versus 51 (range:43–66) mmHg, respectively; p < 0.001)]. There were no significant differences in regional oxygen saturation and fractional oxygen extraction of renal and mesenteric tissues in PDA and control infants (p > 0.05). And ibuprofen treatment did not negatively influence renal and mesenteric oxygenation and extraction in infants with PDA (p > 0.05). Conclusion: Renal and mesenteric tissue oxygenation and oxygen extraction were preserved in preterm infants with a diagnosis of hemodynamically significant PDA treated with oral ibuprofen.

[1]  A. Petrova,et al.  Does Treatment of Patent Ductus Arteriosus With Cyclooxygenase Inhibitors Affect Neonatal Regional Tissue Oxygenation? , 2012, Pediatric Cardiology.

[2]  S. Schulzke,et al.  Oral Ibuprofen versus Intravenous Ibuprofen or Intravenous Indomethacin for the Treatment of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis , 2012, Neonatology.

[3]  J. Gatenby,et al.  Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants , 2010, Journal of Perinatology.

[4]  G. Hansmann,et al.  Patent Ductus Arteriosus of the Preterm Infant , 2010, Pediatrics.

[5]  A. Bos,et al.  Effect of Indomethacin Infused over 30 Minutes on Cerebral Fractional Tissue Oxygen Extraction in Preterm Newborns with a Patent Ductus Arteriosus , 2010, Neonatology.

[6]  C. Roll,et al.  Cerebral blood volume changes during closure by surgery of patent ductus arteriosus , 2007, Archives of Disease in Childhood Fetal and Neonatal Edition.

[7]  R. Clyman,et al.  Patent ductus arteriosus: evidence for and against treatment. , 2007, The Journal of pediatrics.

[8]  M. Sherman,et al.  Near-Infrared Spectroscopy as a Screening Tool for Patent Ductus Arteriosus in Extremely Low Birth Weight Infants , 2006, Neonatology.

[9]  J. Huhta,et al.  The Hemodynamic Effects of Neonatal Patent Ductus Arteriosus Shunting on Superior Mesenteric Artery Blood Flow , 2005, Journal of Perinatology.

[10]  A. Ohlsson,et al.  Ibuprofen for the treatment of patent ductus arteriosus in preterm and/or low birth weight infants. , 2005, The Cochrane database of systematic reviews.

[11]  B. Van Overmeire,et al.  Ibuprofen and cerebral oxygenation and circulation , 2004, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[12]  J. Leblanc,et al.  Comparison of Two Spatially Resolved NIRS Oxygenation Indices , 2002, Journal of Clinical Monitoring and Computing.

[13]  G. Jorch,et al.  Abnormal blood flow patterns in renal arteries of small preterm infants with patent ductus arteriosus detected by Doppler ultrasonography , 1989, European Journal of Pediatrics.

[14]  S A Spencer,et al.  The light still shines, but not that brightly? The current status of perinatal near infrared spectroscopy , 2003, Archives of disease in childhood. Fetal and neonatal edition.

[15]  A. Vianello,et al.  Safety and efficacy of ibuprofen versus indomethacin in preterm infants treated for patent ductus arteriosus: a randomised controlled trial , 2002, European Journal of Pediatrics.

[16]  E. Wodey,et al.  Patent ductus arteriosus and cystic periventricular leucomalacia in preterm infants , 2001, Acta paediatrica.

[17]  J. Weyler,et al.  A comparison of ibuprofen and indomethacin for closure of patent ductus arteriosus. , 2000, The New England journal of medicine.

[18]  F. Piersigilli,et al.  Effects of prophylactic ibuprofen on cerebral and renal hemodynamics in very preterm neonates , 2000, Clinical pharmacology and therapeutics.

[19]  C. W. Yoxall,et al.  Determinants of Cerebral Fractional Oxygen Extraction Using Near Infrared Spectroscopy in Preterm Neonates , 2000, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[20]  P. Persson,et al.  Oxygen and renal hemodynamics in the conscious rat. , 2000, Journal of the American Society of Nephrology : JASN.

[21]  G. Bertini,et al.  Effects of indomethacin and ibuprofen on mesenteric and renal blood flow in preterm infants with patent ductus arteriosus. , 1999, The Journal of pediatrics.

[22]  K. Barrington,et al.  Effects of Ibuprofen and Indomethacin on the Regional Circulation in Newborn Piglets , 1999, Neonatology.

[23]  G. Wright,et al.  In vivo magnetic resonance evaluation of blood oxygen saturation in the superior mesenteric vein as a measure of the degree of acute flow reduction in the superior mesenteric artery: findings in a canine model. , 1997, Academic radiology.

[24]  J. Kiel,et al.  Effect of fasting and refeeding on mesenteric autoregulation in conscious rabbits. , 1992, The American journal of physiology.

[25]  D. Burge Gut blood flow velocities in the newborn: Effects of patent ductus arteriosus and parenteral indomethacin , 1991 .

[26]  Susan Wray,et al.  QUANTIFICATION OF CEREBRAL OXYGENATION AND HAEMODYNAMICS IN SICK NEWBORN INFANTS BY NEAR INFRARED SPECTROPHOTOMETRY , 1986, The Lancet.

[27]  D. Cikrit,et al.  Comparative effects of indomethacin, prostaglandin E1, and ibuprofen on bowel ischemia. , 1983, Journal of pediatric surgery.

[28]  L. Papile,et al.  Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. , 1983, The Journal of pediatrics.

[29]  J. Volpe,et al.  The effect of patent ductus arteriosus on flow velocity in the anterior cerebral arteries: ductal steal in the premature newborn infant. , 1981, The Journal of pediatrics.

[30]  R. Cotton,et al.  Medical management of small preterm infants with symptomatic patent ductus arteriosus. , 1978, The Journal of pediatrics.