Cerebral Near Infrared Spectroscopy Is a Reliable Marker of Systemic Perfusion in Awake Single Ventricle Children

Abstract

Clinical assessment of systemic perfusion in single ventricle patients with parallel circulation can be difficult in the outpatient setting. Near infrared spectroscopy (NIRS) is a noninvasive measure of cerebral oximetry. We measured vital signs, pulse oximetry, and NIRS in 20 single ventricle patients with parallel circulation prior to routine cardiac catheterization. These variables were evaluated to determine the best noninvasive predictor of the superior vena cava saturation (SVC(sat)) as a marker for the adequacy of systemic oxygen delivery. The mean age was 6.7 months [standard deviation (SD), 8.6] and mean weight was 6.5 kg (SD, 2.2). Diagnoses were hypoplastic left heart syndrome (8), tricuspid or pulmonary atresia (10), and double-outlet right ventricle variants (2), all prior to cavo pulmonary anastomoses or complete repairs. Stepwise multiple regression analysis generated a model in which only NIRS was a significant independent predictor of SVC(sat) (p = 0.009). These results support the conclusion that NIRS can be a useful tool to evaluate awake single ventricle patients in the outpatient setting.

Correlation of Cerebral Near-Infrared Spectroscopy (cNIRS) and Neurological Markers in Critically Ill Children

“…Non-invasively determining regional oxygen saturations in organs has been an enticing potential clinical tool for years. Recently, determining RSO 2 in somatic organs has become more accepted as a measure of shock and its resolution [30], but interpretation of CNS data has been problematic in part because normal values have not been well established for various populations. In the operative setting, individual baseline RSO 2 can be obtained prior to the procedure and desaturation events below a given threshold (usually 20%) tracked over time [31,32].…”

Transfusion-Related Necrotizing Enterocolitis

“…77 Near-infrared spectroscopy measures the difference between oxygenated and deoxygenated hemoglobin at the tissue level producing regional saturation (rSO 2 ) of capillary beds where oxygen extraction occurs. 78,79 By applying sensor probes to various parts of the body (eg, head, abdomen, and back), NIRS provides simultaneous monitoring of different tissue beds (brain, gut, and kidney) by revealing differential oxygen extraction reflecting perfusion to various organs. 76 Neonatal studies using NIRS to evaluate splanchnic perfusion have established reference ranges in stable, growing preterm infants, 80 those tolerating feeds, 74 and not tolerating feeds.…”

Application of Near-Infrared Spectroscopy During Fetal Cardiac Surgery

“…The light is either absorbed or scattered back to the sensor's receptors, and the data collected are used to calculate the regional oxygen saturation or rSO 2 . Significant literature has been published regarding the use of this technology during pediatric cardiac surgery and conduct of cardiopulmonary bypass [13][14][15][16][17].…”

“…Near-infrared spectroscopy (NIRS) has proven to be a reliable, noninvasive technique for monitoring regional oxygen delivery in a variety of settings [7][8][9][10][11][12] and, in particular, for assessment of cerebral oxygen 1 [7,11,13]. NIRS technology is based on emission of wavelengths of light in the near infrared spectrum into the tissue beneath the sensor.…”