THE PARAMETERS OF THE OXYGEN STATUS IN THE ASSESSMENT OF PROGNOSIS OF A HEMODYNAMICALLY SIGNIFICANT PATENT DUCTUS ARTERIOSUS PRETERM NEONATAL INFANTS
https://doi.org/10.15360/1813-9779-2015-2-35-41
Abstract
Objective: to estimate the significance of capillary blood oxygen parameters for the prognosis of longstanding hemodynamically significant patent ductus arteriosus (HSPDA) in extremely low birthweight (ELBW) neonates. Subjects and methods. On day 8 of their life, two groups of ELBW newborn infants with and without HSPDA were examined for capillary blood рН, рkО2, %SO2с, O2ct, АkDO2, and RIk, as well as mechanical ventilation (MV) parameters (Pip, MAP, and FiO2). Comparison of two independent samples used nonparametric statistical tests: MannWhitney test, Wald Wolfowitz test, and Kolmogorov-Smirnov test. A logistic regression analysis was used to assess the relationship between the examined parameters and the presence or absence of HSPDA. ROC curves were constructed, by choosing the cut-off point, to estimate the predictive power of the model developed using logistic regression. Results. The developed model has high sensitivity and high specificity (84,6 and 97% respectively). The logistic regression equation takes the form: -0.479•О2сt+0.708•Pip-6.823. Conclusion. Capillary blood oxygen parameters proved suitable for predicting the duration of HSPDA functioning. The resultant good predictive power of the model developed for day 8 of life points to the fact that this period is critical from the viewpoint of resolution of respiratory distress syndrome or development of bronchopulmonary dysplasia, which is crucially significant for MV duration and further prediction. HSPDA is one of the most important factors contributing to the development of bronchopulmonary dysplasia in ELBW neonatal infants.
About the Authors
M. V. PerestoroninaRussian Federation
O. V. Korpacheva
Russian Federation
S. V. Palyanov
Russian Federation
V. T. Dolgikh
Russian Federation
References
1. Perepelitsa S.A., Luchina A.A. Ingalyatsionnaya surfactant-terapiya u novorozhdennykh pri iskusstvennoi ventilyatsii legkikh. Obshchaya Reanimatologiya. [Inhaled surfactant therapy in newborns in artificial lung ventilation. General Reanimatology]. 2014; 10 (5): 44—41. http://dx.doi.org/10.15360/1813-9779-2014-5-44-51. [In Russ.]
2. Zabolotskikh I.B., Sinkov S.V., Velichko D.S., Fedorenko A.A. Arterio venoznaya raznitsa parametrov gemostaza u reanimatsionnykh bolnykh s razlichnymi tipami energodefitsita. Obshchaya Reanimatologiya. [The arteriovenous difference in hemostatic parameters in critically ill patients with different types of energy deficiency. General Reanimatology]. 2013; 9 (4): 23—29. http://dx.doi.org/10.15360/1813-9779-2013-4-23. [In Russ.]
3. Kornilov I.A., Grazhdankin I.O., Redkin D.A., Deryagin M.N., Efremov S.M.,Lomivorotov V.V. Ekstrakorporalnaya membrannaya oksigenatsiya pri ostrom infarkte miokarda, oslozhnennom kardiogennym shokom. Obshchaya Reanimatologiya. [Extracorporeal membrane oxygenation in acute myocardial infarction complicated by cardiogenic shock. General Reanimatology]. 2013; 9 (3): 54—57. http://dx.doi.org/10.15360/1813-9779-2013-3-54. [In Russ.]
4. Savilov P.N., Dyachkova S.Ya., Turovsky A.Ya., Yakovlev V.N. Vliyanie giperbaricheskoi oksigenatsii na antistafilokokkovuyu aktivnost krovi pri eksperimentalnoi rezektsii pecheni. Obshchaya Reanimatologiya. [Impact of hyperbaric oxygenation on blood antistaphylococcal activity during experimental liver resection. General Reanimatology]. 2013; 9 (5): 56—61. http://dx.doi.org/10.15360/1813-9779-2013-5-56. [In Russ.]
5. Pykov M.I., Efimov M.S., Vokueva T.I. Vliyanie gemodinamicheski znachimogo otkrytogo arterialnogo protoka na pokazateli tsentralnoi gemodinamiki i organnogo krovotoka u nedonoshennykh novorozh dennykh. [Impact of hemodynamically significant patent ductus arte riosus on the parameters of central hemodynamics and organ blood flow in preterm neonatal infants]. Ultrazvukovaya i Funktsionalnaya Diagnostika. 2008; 3: 26—34. [In Russ.]
6. Perepelitsa S.A., Golubev A.M., Moroz V.V., Shmakova M.A. Prenatalnyi morfogenez legkikh i predposylki dlya razvitiya RDS u nedonoshen nykh novorozhdennykh. Obshchaya Reanimatologiya. [Prenatal lung morphogenesis and prerequisites for the development of respiratory distress syndrome in premature neonates. General Reanimatology]. 2010; 6 (6): 53—58. http://dx.doi.org/10.15360/1813-9779-2010-6-53. [In Russ.]
7. Samokhin P.A., Tsvetkova Yu.V. Bronkholegochnaya displaziya novorozhdennogo: morfogenez, mogfologicheskaya diagnostika. [Neonatal bronchopulmonary dysplasia: morphogenesis, morphological diagnosis]. Arkhiv Patologii. 2008; 70 (4): 37-42. PMID: 18807526. [In Russ.]
8. Farber H.W., Loscalzo J. Mechanism of disease: pulmonary hypertension. Discov. Med. 2005; 5 (25): 80-87. PMID: 20704929
9. King M.A., Garrison M.M., Vavilala M.S., Zimmerman J.J., Rivara F.P. Complications associated with arterial catheterization in children. Pediatr. Crit. Care Med. 2008; 9 (4): 367—371. http://dx.doi.org/10.1097/PCC.0b013e318172d94f. PMID: 18496411
10. Vasquez P., Burd A., Mehta R., Hiatt M., Hegyi T. Resolution of peripheral artery catheter-induced ischemic injury following prolonged treatment with topical nitroglycerin ointment in a newborn: a case report. J. Perinatol. 2003; 23 (4): 348—350. http://dx.doi.org/10.1038/ sj.jp.7210870. PMID: 12774147
11. Volodin N.N. (red.). Neonatologiya. Natsionalnoe rukovodstvo. [Neonatology. National guidelines]. Moscow: GEOTARMedia; 2009: 848. [In Russ.]
12. Perepelitsa S.A., Golubev A.M., Moroz V.V. Respiratornyi distress-sindrom novorozhdennykh: rannyaya diagnostika, profilaktika i lechenie. Obshchaya Reanimatologiya. [Neonatal respiratory distress syndrome: early diagnosis, prevention, and treatment. General Reanimatology]. 2012; 8 (4): 95—102. http://dx.doi.org/10.15360/1813-9779-2012-4-95. [In Russ.]
13. Yildizdas D., Yapicioglu H., Yilmaz H.L., Sertdemir Y. Correlation of simultaneously obtained capillary, venous, and arterial blood gases of patients in a paediatric intensive care unit. Arch. Dis. Child. 2004; 89(2): 176—180. http://dx.doi.org/10.1136/adc.2002.016261. PMID: 14736638
14. Ovsyannikov D.Yu., Kuzmenko L.G. (red.). Sistema okazaniya meditsinskoi pomoshchi detyam, stradayushchim bronkholegochnoi displaziei. [The healthcare system for children with bronchopulmonary dysplasia]. Moscow: MDV; 2010: 152. [In Russ.]
15. Vlasov V.V. Effektivnost diagnosticheskikh issledovanii. [The effectiveness of diagnostic tests]. Moscow: Meditsina Publishers; 1988: 245. [In Russ.]
16. Petri A., Sebin K. Naglyadnaya statistika v meditsine. [Transparent statistics in medicine]. Moscow: GEOTARMedia; 2003: 144. [In Russ.]
17. Malyshev V.D. Kislotnoosnovnoe sostoyanie i vodno-elektrolitnyi balans v intensivnoi terapii. [Acid-base status and fluid and electrolyte balance in intensive care]. Moscow; 2005: 228. [In Russ.]
18. Zilber A.P. Klinicheskaya patofiziologiya v anesteziologii i reanimatologii. [Clinical pathophysiology in anesthesiology and intensive care]. Moscow: Meditsina Publishers; 1984: 480. [In Russ.]
19.
Review
For citations:
Perestoronina M.V., Korpacheva O.V., Palyanov S.V., Dolgikh V.T. THE PARAMETERS OF THE OXYGEN STATUS IN THE ASSESSMENT OF PROGNOSIS OF A HEMODYNAMICALLY SIGNIFICANT PATENT DUCTUS ARTERIOSUS PRETERM NEONATAL INFANTS. General Reanimatology. 2015;11(2):35-41. https://doi.org/10.15360/1813-9779-2015-2-35-41