NIRS Monitoring to Detect AKI in Preterm Infants (nNIRS-AKI)
Use of NIRS to Detect Acute Kidney Injury in Preterm Infants
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This prospective, single-center study was conducted at UnityPoint Health-Meriter Hospital (Madison, WI, USA) in preterm neonates admitted to a level III NICU from April 2018 to August 2019. The primary study aim was to assess changes in RrSO2 with continuous renal NIRS monitoring to detect AKI during the first 7 days of age.
The INVOS 5100 C (Somanetics, Troy, MI, USA) four channel NIRS monitors were used to measure RrSO2 (measured at the right or left flank) and Cerebral regional Somatic tissue Oxygenation (CrSO2; measured at the forehead) for all neonates. At each measurement site, for skin protection, subjects had a transparent Mepitel (with Safetac Technology, Norcross, GA) adhesive dressing placed with the adhesive neonatal NIRS sensor (INVOS OxyAlert NIRSensor, Covidien) adhered over the Mepitel dressing. Neither cerebral or kidney sensors were placed with ultrasound guidance. Tissue oxygenation was recorded every 3 seconds until 7 days of age, and the sensor was changed one time when the patient reached three to four days of age per the company's recommendation. There were no restrictions on positioning or handling of neonates; nurses re-positioned neonates every 3-6 hours per unit protocol to prevent skin pressure injuries. Researchers, staff, and parents were blinded to RrSO2 values.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
Wisconsin
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Madison, Wisconsin, United States, 53715-1507
- UnityPoint Health Meriter Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Preterm infants < 32 weeks
- Admitted to Unity Point Health(UPH) Meriter Newborn Intensive Care Unit (NICU)
- Application of NIRS by 48 hours of age
Exclusion Criteria:
- Congenital anomaly of the kidney or urinary tract (CAKUT)
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
NIRS monitoring
These infants will be monitored with NIRS
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Application of regional NIRS sensors to brain and kidney sites in the first 48 hours after birth to monitor regional tissue oxygenation for the first 7 days of age.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Renal NIRS Tissue Oxygenation Differential
Time Frame: Up to 1 week
|
Comparison of Renal saturation (Rsat) in neonates with AKI to those without AKI. RSO2 will be recorded until 7 days of age. Median RSO2 for 1 week and median for individual days 2-7 will be calculated. The INVOS 5100 C (Somanetics, Troy, MI, USA) four channel NIRS monitors will be used to measure renal regional oxygenation (RrSO2) values for all neonates. |
Up to 1 week
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Correlation of Renal NIRS Values to Serum Creatinine
Time Frame: Days 1-7 of age
|
At each time a serum creatinine was collected, the RrSO2 value was recorded.
|
Days 1-7 of age
|
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Correlation of Renal NIRS Values to Urine Output
Time Frame: Days 1-7 of age
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In patients with urine output recorded, it was compared to RrSO2 values
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Days 1-7 of age
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Baseline Renal NIRS Values Before Caffeine
Time Frame: Baseline (6 hours prior to caffeine dose)
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these are the average renal NIRS values over 6 hours prior to a dose of caffeine broken down by percentage
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Baseline (6 hours prior to caffeine dose)
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Renal NIRS Values 1 Hour After Caffeine
Time Frame: At 1 hour after caffeine dose
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Renal NIRS values one hour after caffeine broken down by baseline average.
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At 1 hour after caffeine dose
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Renal NIRS Values 2 Hours After Caffeine
Time Frame: At 2 hours after caffeine dose
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Renal NIRS values 2 hours after caffeine broken down by baseline average
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At 2 hours after caffeine dose
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Renal NIRS Values 3 Hours After Caffeine
Time Frame: At 3 hours after caffeine dose
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Renal NIRS values 3 hours after caffeine broken down by baseline average
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At 3 hours after caffeine dose
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Renal NIRS Values 4 Hours After Caffeine
Time Frame: At 4 hours after caffeine dose
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Renal NIRS values 4 hours after caffeine broken down by baseline average
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At 4 hours after caffeine dose
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Renal NIRS Values 6 Hours After Caffeine
Time Frame: At 6 hours after caffeine dose
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Renal NIRS values 6 hours after caffeine broken down by baseline average
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At 6 hours after caffeine dose
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Matthew W Harer, MD, University of Wisconsin, Madison
Publications and helpful links
General Publications
- Chock VY, Rose LA, Mante JV, Punn R. Near-infrared spectroscopy for detection of a significant patent ductus arteriosus. Pediatr Res. 2016 Nov;80(5):675-680. doi: 10.1038/pr.2016.148. Epub 2016 Sep 7.
- Ruf B, Bonelli V, Balling G, Horer J, Nagdyman N, Braun SL, Ewert P, Reiter K. Intraoperative renal near-infrared spectroscopy indicates developing acute kidney injury in infants undergoing cardiac surgery with cardiopulmonary bypass: a case-control study. Crit Care. 2015 Jan 29;19(1):27. doi: 10.1186/s13054-015-0760-9.
- Hazle MA, Gajarski RJ, Aiyagari R, Yu S, Abraham A, Donohue J, Blatt NB. Urinary biomarkers and renal near-infrared spectroscopy predict intensive care unit outcomes after cardiac surgery in infants younger than 6 months of age. J Thorac Cardiovasc Surg. 2013 Oct;146(4):861-867.e1. doi: 10.1016/j.jtcvs.2012.12.012. Epub 2013 Jan 12.
- Owens GE, King K, Gurney JG, Charpie JR. Low renal oximetry correlates with acute kidney injury after infant cardiac surgery. Pediatr Cardiol. 2011 Feb;32(2):183-8. doi: 10.1007/s00246-010-9839-x. Epub 2010 Nov 19.
- McNeill S, Gatenby JC, McElroy S, Engelhardt B. Normal cerebral, renal and abdominal regional oxygen saturations using near-infrared spectroscopy in preterm infants. J Perinatol. 2011 Jan;31(1):51-7. doi: 10.1038/jp.2010.71. Epub 2010 Jun 10.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2017-0589
- 2017-013 (Other Identifier: Meriter IRB)
- A536757 (Other Identifier: UW- Madison)
- SMPH/PEDIATRICS/PEDIATRICS (Other Identifier: UW Madison)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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