MONITORING OF RENAL TISSUE OXYGENATION IN YOUNG CHILDREN WITH CONGENITAL HEART DISEASE IN THE PERIOPERATIVE PERIOD
Abstract
Introduction. Tissue oximetry is one of the most promising methods for assessing the efficiency of systemic perfusion in children in critical condition, which is especially true for newborns with heart defects, but it is not a routine method of diagnosing systemic hypoperfusion in neonatal intensive care units, which requires its wider implementation. The aim of the study is to demonstrate the possibilities of prolonged NIRS-monitoring of renal tissue oxygenation to determine further tactics of management of newborns with congenital heart disease. Patients and methods. Three clinical cases of prolonged noninvasive monitoring of renal oxygenation in infants with congenital heart disease accompanied by systemic hypoperfusion in the perioperative period are presented. Results. It was demonstrated that on the basis of renal tissue oxygenation indices it is possible to make an informed decision on the correction of intensive care measures and the need for emergency cardiac surgery. In some cases, NIRS-monitoring allows to avoid early intubation and invasive ventilation of lungs, which is reflected in the description of the third case. Conclusion. Noninvasive real-time bedside monitoring of tissue oxygenation is a highly eff ective method of diagnosing systemic hypoperfusion and should be more widely used in neonatal intensive care units, especially in neonates with CHD, in whom the risk of shock of various genesis is extremely high.
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