Regional venous oxygen saturation versus mixed venous saturation after paediatric cardiac surgery

Background Central venous oxygen saturation (ScvO2) remains the gold standard surrogate for tissue oxygen extraction in paediatric cardiac surgery. Near‐infrared spectroscopy (NIRS) has been developed as a non‐invasive diagnostic tool for regional oxygen saturation. The aim was to compare regional o...

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Published in:	Acta anaesthesiologica Scandinavica Vol. 57; no. 3; pp. 373 - 379
Main Authors:	MORENO, G. E., PILÁN, M. L., MANARA, C., MAGLIOLA, R., VASSALLO, J. C., BALESTRINI, M., LENZ, A. M., KRYNSKI, M., ALTHABE, M., LANDRY, L.
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-03-2013 Wiley Subscription Services, Inc
Subjects:	Arrhythmias, Cardiac - diagnosis Blood Gas Analysis - methods Cardiac Output, Low - diagnosis Cardiac Surgical Procedures Female Heart Defects, Congenital - surgery Heart Ventricles - abnormalities Heart Ventricles - surgery Humans Hypotension - diagnosis Infant Infant, Newborn Male Oximetry - methods Oxygen - blood Predictive Value of Tests Prospective Studies Spectroscopy, Near-Infrared
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Summary:	Background Central venous oxygen saturation (ScvO2) remains the gold standard surrogate for tissue oxygen extraction in paediatric cardiac surgery. Near‐infrared spectroscopy (NIRS) has been developed as a non‐invasive diagnostic tool for regional oxygen saturation. The aim was to compare regional oxygen saturation measured by NIRS with ScvO2 in postoperative paediatric cardiac patients. Methods In this prospective study, we included newborns and infants younger than 45 days undergoing heart surgery. We recorded continuous ScvO2 and NIRS regional saturation placed on the forehead (B) and right flank (S) for 48 h postoperatively. A Bland–Altman's analysis was used to assess the agreement between these measurements. Results A total of 23 patients were included with a median age of 12 days (2–46) and median weight of 3.1 kg (2.3–4.47). The mean difference (MD) ScvO2‐ B NIRS was 10.45% with limits of agreement (LOA) −17.23 to 38.13% and ScvO2‐ S NIRS MD 7.16% with LOA: −25.51 to 39.84%. The single ventricle ScvO2‐ S NIRS subgroup had MD within ± 5%; however, wide LOA was observed. The remaining subgroups showed MD nearly above ± 5%, with wide LOA. Conclusions The regional oxygen saturation of brain and kidney did not match ScvO2 as estimation of global tissue perfusion. Nevertheless, NIRS may still provide information regarding regional circulation that may help in the management of neonatal cardiac surgery patients.
Bibliography:	ArticleID:AAS12016 Education and Research Department at Hospital of Pediatría 'Dr Juan P. Garrahan' istex:C79D4124B9799BA3CCF5EDBED70DE68568162481 ark:/67375/WNG-F1D9RJL9-0 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0001-5172 1399-6576
DOI:	10.1111/aas.12016