Regional oxygen saturation as a non-invasive indicator for neonatal PDA: a systematic review and meta-analysis

The high prevalence of patent ductus arteriosus (PDA) in preterm neonates, particularly those born before 32 weeks of gestation, highlights the need for early diagnosis, where altered oxygen saturation levels are considered a potential indicator. This review evaluates the diagnostic value of multisite oxygen saturation indices for neonatal PDA. Relevant studies were sourced from PubMed, Embase, Web of Science, and Cochrane Library up to June 2023, using both medical subject headings and keywords. The quality of studies was assessed via American Agency for Healthcare Research and Quality criteria. Data were analyzed using the random effect model to calculate standardized mean differences (SMD) and 95% confidence intervals (CIs). A total of 9 studies were eligible and were included in the analysis. The random-effect meta-analysis showed that in the PDA group, the cerebral regional oxygen saturation (rSO2) that detected by NIRS technique were significantly lower than that in the control group [SMD (95%CI)=-0.42 (-0.74, -0.10)]. No significant changes were found in renal rSO2, peripheral oxygen saturation (SpO2), cerebral fractional tissue oxygen extraction (FTOE), and renal FTOE in PDA cases. Lower cerebral rSO2 in PDA infants suggests its potential as a non-invasive diagnostic marker. Future research should focus on validating these results through diagnostic performance analysis, particularly area under the curve (AUC) studies. PROSPERO, CRD42023480460.