Low Rsat < 66% was associated with the presence of an hsPDA in the preterm infant. Csat may be preserved if cerebral autoregulation is largely intact. Bedside NIRS monitoring may reasonably increase suspicion for a significant PDA in the preterm infant.

Objective: Decreased near-infrared spectroscopy (NIRS) measures of renal oxygen saturation (Rsat) have identified preterm infants with a hemodynamically significant patent ductus arteriosus (hsPDA). NIRS may further identify infants at risk for acute kidney injury (AKI) in a population with concern for hsPDA. Design: Review of infants ≤29 weeks gestation undergoing NIRS and echocardiography due to concern for hsPDA. The hsPDA was defined by two of the following: moderate-large size, left to right shunt, aortic flow reversal, left atrial enlargement. AKI was defined by neonatal modified Kidney Disease Improving Global Outcomes (KDIGO). Rsat and cerebral saturation (Csat), averaged over 1 hour, were evaluated for the 24 hour period around echocardiography. Result: Among 77 infants, 29 (38%) had AKI by neonatal modified KDIGO criteria. hsPDA was found on echocardiography in 59 (77%). There were no differences in hsPDA in infants with and without AKI (p=0.1). Rsat was not associated with AKI (p=0.3). Infants on dopamine had less Rsat variability (p<0.01). Conclusion: Rsat prior to echocardiography did not discriminate AKI in this cohort of preterm infants at risk for hsPDA, however data may not capture optimal timing of Rsat measurement before AKI.

Objective: Decreased near-infrared spectroscopy (NIRS) measures of renal saturation (Rsat) have identified hemodynamically significant PDA (hsPDA) and may delineate infants at risk for acute kidney injury (AKI). Design: Review of infants 29 weeks gestation undergoing NIRS and echocardiography due to concern for PDA. hsPDA was defined by two of the following: moderate-large size, left to right shunt, aortic flow reversal, left atrial enlargement. AKI was defined by neonatal KDIGO. Rsat and cerebral saturation (Csat) were evaluated for 24 hours before echocardiography. Result: Among 77 infants, hsPDA was found on echocardiography in 59 (77%). There were no differences in hsPDA in infants with and without AKI. Rsat was not associated with AKI (p=0.3) or hsPDA (p=0.5). Infants on dopamine had less Rsat variability (p=0.001). Conclusion: Rsat prior to echocardiography did not discriminate AKI in the preterm hsPDA population, however data may not capture optimal timing of Rsat measurement before AKI.