Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients

• Published in: Pediatric anesthesia 2008-12, Vol.18 (12), p.1163-1169
• Main Authors: RANUCCI, MARCO, ISGRÒ, GIUSEPPE, DE LA TORRE, TERESA, ROMITTI, FEDERICA, CONTI, DANIELA, CARLUCCI, CONCETTA
• Format: Article
• Language: English
• Subjects: Brain Chemistry; Calibration; cardiac surgery; Cardiac Surgical Procedures; Child; Child, Preschool; congenital heart disease; Female; Humans; Infant; Infant, Newborn; Linear Models; Male; near-infrared spectroscopy; Oximetry; Oxygen - blood; Prospective Studies; Spectroscopy, Near-Infrared - methods; Vena Cava, Superior - physiology
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1111/j.1460-9592.2008.02783.x

Summary Background:  Cerebral regional oxygen saturation (rSO2) measured with near‐infrared spectroscopy (NIRS) has a well‐proven clinical utility. A goal‐oriented treatment based on the rSO2 resulted in a significant reduction in major morbidity and in a shortening of postoperative hospital stay in patients undergoing coronary revascularization. In this study, we have compared the values of superior vena cava saturation (ScvO2) continuously measured with a Pediasat catheter and the corresponding NIRS rSO2 values obtained during cardiac operations in pediatric patients. Methods:  This was a prospective observational study enrolling fifteen pediatric patients (age: 6 days–7 years) undergoing cardiac operations. ScvO2 data obtained with the Pediasat during the operation were compared with simultaneously recorded NIRS rSO2 values. Results:  One hundred and seventeen matched sets of data were obtained during the operation. ScvO2 continuously measured with the Pediasat was significantly correlated with the corresponding NIRS rSO2 values. However, there was a constant positive bias (ScvO2 values were higher than NIRS rSO2 values) of 5.6%, with a precision of 10.4%. Time‐related percentage changes of NIRS rSO2 were significantly correlated with the corresponding ScvO2 percentage changes. A decrease in ScvO2 is predictive for a decrease in rSO2 with a sensitivity of 73.7% and a specificity of 85.7%. Conclusions:  The continuous measurement of ScvO2 values obtained by the Pediasat may provide useful information about the metabolic conditions of the brain during cardiac operations in pediatric patients if considered as percentage changes. Absolute values of ScvO2 tend to overestimate the correspondent rSO2 values.