Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children

• Published in: Intensive care medicine Vol. 31; no. 6; pp. 846 - 850
• Main Authors: NAGDYMAN, Nicole, FLECK, Thilo, SCHUBERT, Stephan, EWERT, Peter, PETERS, Björn, LANGE, Peter E, ABDUL-KHALIQ, Hashim
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01-06-2005; Berlin Springer Nature B.V
• Subjects: Adolescent; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood and lymphatic vessels; Brain - blood supply; Cardiac Catheterization; Cardiology. Vascular system; Child; Child, Preschool; Cyanosis; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart Defects, Congenital; Humans; Infant; Intensive care medicine; Investigative techniques, diagnostic techniques (general aspects); Jugular Veins - metabolism; Linear Models; Male; Medical sciences; Nervous system; Observation; Oximetry - methods; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Sensitivity and Specificity; Spectroscopy, Near-Infrared; Human; Jugular bulb; Oxygen; Intensive care; Saturation; Central nervous system; Cardiovascular disease; Jugular venous oxygen saturation; Congenital heart defects; Encephalon; Near-infrared spectroscopy; Tissue oxygenation index; Cerebral oxygenation; Nervous tissue; Children; Congenital cardiopathy; Oxygenation; Child; Comparative study; Resuscitation
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-005-2618-0

To compare the cerebral tissue oxygenation index (TOI) measured by near-infrared spectroscopy (NIRS) with venous oxygen saturation in the jugular bulb (SjO(2)) during elective cardiac catheterization in children.
Prospective observational clinical study in a catheterization laboratory for pediatric cardiology.
Sixty children with congenital heart defects admitted to the catheterization laboratory.
TOI measured noninvasively by NIRS was compared to SjO(2) measured in the jugular bulb during cardiac catheterization. Patients were divided into two groups regarding body weight: below (n=29) and above 10 kg (n=31). Linear regression analysis and Pearson's correlation coefficient were calculated. Bland-Altman analysis, sensitivity, and specificity calculation for spatially resolved near-infrared spectroscopy with a cutoff level of 60% were performed. Simultaneously measured values for SjO(2) (67.3+/-9.8%, 40-84.1%) and TOI (65.7+/-7.2%, 39-80%) showed a significant correlation; the correlation in children weighing under 10 kg was stronger in children weighing over 10 kg. Bland-Altman analysis showed a mean bias of -1.8% with limits of agreement between 11.7% and -15.3% for all children. Sensitivity and specificity of the SRS method were 46% and 91%, respectively, for all children and 53% and 83% respectively in infants weighing under 10 kg.
The results demonstrate that despite a significant correlation, sensitivity of spatially resolved spectroscopy is poor, and it is questionable whether TOI can be used reliably to detect low SjO(2).