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Impact of catheterized ductal closure on renal and cerebral oximetry in premature neonates

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Abstract

Percutaneous catheter-based closure is increasingly utilized in premature newborns. While near-infrared spectroscopy (NIRS) has been examined for assessment of interventional closure in surgical ligation, its application in percutaneous transcatheter closure remains unexplored. This study aims to assess cerebral and renal hemodynamic changes using NIRS during percutaneous closure compared to surgical closure in preterm infants. A prospective observational study enrolled preterm infants born at 32 weeks of gestation or less and diagnosed with hsPDA between January 2020 and December 2022. These infants received either surgical or catheter-based closure of the PDA. Cerebral and renal oxygen saturation was monitored using the INVOS 5100 device from 12 h before the intervention until 24 h after. Linear mixed-effects models were used to analyze time-dependent variables. Twenty-two patients were enrolled, with catheter-based closure performed in 16 cases and conventional surgery in 6 cases. Following ductal closure, a significant increase in renal and cerebral oximetry was observed alongside a decrease in renal and cerebral tissue oxygen extraction. These changes were particularly pronounced in the renal territory. No differences were detected between catheterization and surgical closure.

  Conclusion: An improvement in cerebral and renal oximetry following hsPDA closure was observed. However, we did not identify differences in this pattern based on the type of interventional procedure for PDA, whether surgery or catheterization.

What is Known:

• The presence of a significant ductus is common in premature patients. Studies have shown that it affects cerebral and renal hemodynamics negatively, leading to decreased oximetry values in these areas. It has been reported that closure of the ductus, either pharmacologically or surgically, results in improved oximetry values.

What is New:

• This study assess the impact of percutaneous closure of ductus, revealing increased oximetry values in cerebral and renal territories without significant differences compared to surgical ligation. Notably, renal oximetry values showed a greater increase, underscoring the importance of multi-location monitoring.

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Data availability

No datasets were generated or analysed during the current study.

Code availability

Not applicable

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Funding

This study received funding through a research grant from the Spanish Society of Neonatology.

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Authors and Affiliations

  1. Neonatology Department, Gregorio Marañón University Hospital (HGU), C/Maiquez 9, Madrid, 28009, Spain

    María Arriaga-Redondo, Ana Rodríguez-Sánchez de la Blanca, Dorita Blanco-Bravo & Manuel Sánchez-Luna

  2. Pediatric Cardiology Department, Gregorio Marañón University Hospital, Madrid, Spain

    José Luis Zunzunegui, Fernando Ballesteros-Tejerizo & Alejandro Rodríguez-Ogando

  3. Unidad de Investigación Materno Infantil-Fundación Familia Alonso (UDIMIFFA)-Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain

    Pablo González-Navarro

Authors
  1. María Arriaga-Redondo
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  2. Ana Rodríguez-Sánchez de la Blanca
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  3. José Luis Zunzunegui
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  4. Fernando Ballesteros-Tejerizo
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  5. Alejandro Rodríguez-Ogando
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  6. Pablo González-Navarro
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  7. Dorita Blanco-Bravo
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  8. Manuel Sánchez-Luna
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Contributions

 Conceptualization: M.A.R, A.R.S.B, A.R.O; methodology MAR, ARSB; validation MSL, JLZ, FB, DBB; formal analysis MAR, PGN; investigation MAR, ARSB; writing—original draft preparation MAR; review and supervision MSL, DBB, JLZ, ARSB, FB, ARO. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to María Arriaga-Redondo.

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Ethics approval

This study has been conducted in accordance with the Declaration of Helsinki and following the Spanish law (Ley Orgánica de protección de datos 3/2018). This study was approved by the ethics committee of the hospital: Comité de Ética de la Investigación con Medicamentos Hospital General Universitario Gregorio Marañón (Committee for Research Ethics in Medicine Research Hospital General Universitario Gregorio Marañón)

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Informed consent was obtained from parents.

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Daniele De Luca

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Arriaga-Redondo, M., Rodríguez-Sánchez de la Blanca, A., Zunzunegui, J.L. et al. Impact of catheterized ductal closure on renal and cerebral oximetry in premature neonates. Eur J Pediatr 183, 2753–2761 (2024). https://doi.org/10.1007/s00431-024-05541-3

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  • DOI: https://doi.org/10.1007/s00431-024-05541-3

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