Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec;52(6):1958-1969.
doi: 10.55730/1300-0144.5544. Epub 2022 Dec 21.

Monitoring renal oxygenation status by near-infrared spectroscopy during ureterorenoscopy in children

Sema Şanal Baş  1 , Meryem Onay  2 , Çiğdem Arslan Alıcı  3 , Umut Alıcı  3 , Baran Tokar  3
Affiliations

Monitoring renal oxygenation status by near-infrared spectroscopy during ureterorenoscopy in children

Sema Şanal Baş et al. Turk J Med Sci. 2022 Dec.

Abstract

Background: : Near-infrared spectroscopy (NIRS) monitoring demonstrates renal blood flow, perfusion, and oxygenation changes. This study aimed to evaluate the effects of pediatric endourological interventions (PEI) on regional oxygen saturation value (rSO2) usingrenal NIRS monitoring.

Methods: Patients having bilateral inguinal surgery (group I), cystoscopy (group II), and ureterorenoscopy (group III), 20 patients in each group, were included in the study. NIRS values before induction (T0) and at 5 min (T5), 10 min (T10), 15 min (T15), 20 min (T20), 25 min (T25), 30 min (T30) of the surgical procedure, and at the postextubation (Tend) were determined. The amount of irrigation fluid was recorded in groups II and III. The ureterorenoscopy group was also evaluated as two subgroups, as group III-R with patients having a "20%↓rSO2" and as group III-NoR, not having a "20%↓rSO2".

Results: The mean total volume of irrigation was higher in group III, but the difference was not significant between the subgroups III-R and III-NoR. Renal rSO2 decreased significantly in T25, T30, and T-end values in group III. "20%↓rSO2" was seen in 1 patient in group II and 7 patients in group III. In the subgroups III-R, all patients had an obstructive pathology and significant preoperative hydronephrosis with a mean renal pelvis AP diameter of 21.1 ± 16.4 mm.

Discussion: Although rSO2 significantly improves postoperatively, our data may suggest that congenital and acquired obstructive pathologies with hydronephrosis, prolonged operative time with continuous irrigation, and instrument movement in a narrow lumen may increase intrarenal pressure and the risk of renal hypoxia in endourological interventions. Preoperative evaluation of kidney functions and a meticulously well-planned intervention can prevent possible complications.

Keywords: Near-infrared spectroscopy; children; endourology; renal oxygenation.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Changes in left renal regional oxygen saturation index during perioperative period.
Figure 2
Figure 2
Changes in right renal regional oxygen saturation index during perioperative period.
Figure 3
Figure 3
Irrigation fluid of group II (C) and group III (U).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Osther PJ, Pedersen KV, Lildal SK, Pless MS. Pathophysiological aspects of ureterorenoscopic management of upper urinary tract calculi. Current Opinion in Urology. 2016;26(1):63–69. doi: 10.1097/MOU.0000000000000235. - DOI - PubMed
    1. Jung HU, Frimodt-Møller PC, Osther PJ, Mortensen J. Pharmacological effect on pyeloureteric dynamics with a clinical perspective: a review of the literature. Urological Research. 2006;34:341–350. doi: 10.1007/s00240-006-0069-x. - DOI - PubMed
    1. Traxer O, Thomas A. Prospective evaluation and classification of ureteral wallinjuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. The Journal of Urology. 2013;189:580–584. doi: 10.1016/j.juro.2012.08.197. - DOI - PubMed
    1. Jung H, Osther PJ. Intraluminal pressure profiles during flexible ureterorenoscopy. Springerplus. 2015;4:373. doi: 10.1186/s40064-015-1114-4. - DOI - PMC - PubMed
    1. Tokas T, Herrmann TRW, Skolarikos A, Nagele U. Training and Research in Urological Surgery and Technology (T.R.U.S.T.)-Group. Pressure matters: intrarenal pressures during normal and pathological conditions, and impact of increased values to renal physiology. World Journal of Urology. 2019;37(1):125–131. doi: 10.1007/s00345-018-2378-4. - DOI - PubMed