Combined Cerebral and Renal Near-Infrared Spectroscopy After Congenital Heart Surgery

2015 ◽  
Vol 36 (6) ◽  
pp. 1173-1178 ◽  
Author(s):  
Javier Gil-Anton ◽  
Silvia Redondo ◽  
Diego Garcia Urabayen ◽  
Manuel Nieto Faza ◽  
Irene Sanz ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Near Infrared ◽  
Congenital Heart Surgery

The Correlation of Two Cerebral Saturation Monitors With Jugular Bulb Oxygen Saturation in Children Undergoing Cardiopulmonary Bypass for Congenital Heart Surgery

2016 ◽  
Vol 32 (10) ◽  
pp. 603-608 ◽  
Author(s):  
Aymen N. Naguib ◽  
Peter D. Winch ◽  
Roby Sebastian ◽  
Daniel Gomez ◽  
Luisa Guzman ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Near Infrared ◽  
Jugular Bulb ◽  
Congenital Heart Surgery ◽  
Cerebral Oxygen ◽  
Cerebral Saturation

Background: Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional cerebral oxygen saturation (rSO2). Objectives: The primary aim was to compare the output of 2 NIRS-based cerebral oximetry devices, FORESIGHT (CAS Medical Systems Inc, Branford, Connecticut) and INVOS (Covidien, Boulder, Colorado), to venous oxygen saturations from the jugular venous bulb at cannulation and decannulation of the superior vena cava (SVC). Secondary objectives included evaluating correlations of cerebral saturation, as measured by the NIRS devices, with mean arterial blood pressure (MAP), measured by an invasive arterial line, and end-tidal CO2 (ETCO2). Methods: Near-infrared spectroscopy, MAP, and ETCO2 data were collected at 13 defined events during each case when hemodynamic instability was expected. At SVC cannulation and decannulation, a 0.1 mL sample of blood was collected from the jugular bulb by the surgeon using a long angiocatheter. The oxygen saturation of these blood samples was measured using an AVOX device and compared with contemporaneous readings from the NIRS probes. Mixed-effects linear regression was used to correlate MAP or ETCO2 with cerebral oxygen saturation (by NIRS) at each time point. Results: Children undergoing cardiopulmonary bypass for congenital heart surgery (n = 34) were enrolled in the study. At SVC cannulation, both INVOS ( r = .78) and FORESIGHT ( r = .59) were correlated with AVOX data at P < .001, although the correlation with INVOS was significantly stronger ( P = .003). At SVC decannulation, INVOS ( r = .68; P < .001) and FORESIGHT ( r = .60; P < .001) were similarly correlated with jugular venous rSO2. Correlations of rSO2 (by NIRS) with MAP and ETCO2 levels were stronger than correlations between rSO2 change and change in MAP or ETCO2. Conclusion: INVOS correlated more strongly than FORESIGHT with the jugular bulb rSO2 at SVC cannulation but may have underestimated oxygen saturation at low rSO2 values. Data from both NIRS devices were correlated with MAP and ETCO2 over the case duration.

scholarly journals Near-infrared spectroscopy after high-risk congenital heart surgery in the paediatric intensive care unit

2014 ◽  
Vol 25 (3) ◽  
pp. 459-467 ◽  
Author(s):  
Lyvonne N. Tume ◽  
Philip Arnold
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Heart Surgery ◽  
Near Infrared ◽  
Inverse Correlation ◽  
Congenital Heart Surgery ◽  
Serum Lactate ◽  
Venous Oxygen Saturation

AbstractObjective: To establish whether the use of near-infrared spectroscopy is potentially beneficial in high-risk cardiac infants in United Kingdom paediatric intensive care units. Design: A prospective observational pilot study. Setting: An intensive care unit in North West England. Patients: A total of 10 infants after congenital heart surgery, five with biventricular repairs and five with single-ventricle physiology undergoing palliation. Interventions: Cerebral and somatic near-infrared spectroscopy monitoring for 24 hours post-operatively in the intensive care unit. Measurement and main results: Overall, there was no strong correlation between cerebral near-infrared spectroscopy and mixed venous oxygen saturation (r=0.48). At individual time points, the correlation was only strong (r=0.74) 1 hour after admission. The correlation was stronger for the biventricular patients (r=0.68) than single-ventricle infants (r=0.31). A strong inverse correlation was demonstrated between cerebral near-infrared spectroscopy and serum lactate at 3 of the 5 post-operative time points (1, 4, and 12 hours: r=−0.76, −0.72, and −0.69). The correlation was stronger when the cerebral near-infrared spectroscopy was <60%. For cerebral near-infrared spectroscopy <60%, the inverse correlation with lactate was r=−0.82 compared with those cerebral near-infrared spectroscopy >60%, which was r=−0.50. No correlations could be demonstrated between (average) somatic near-infrared spectroscopy and serum lactate (r=−0.13, n=110) or mixed venous oxygen saturation and serum lactate. There was one infant who suffered a cardiopulmonary arrest, and the cerebral near-infrared spectroscopy showed a consistent 43 minute decline before the event. Conclusions: We found that cerebral near-infrared spectroscopy is potentially beneficial as a non-invasive, continuously displayed value and is feasible to use on cost-constrained (National Health Service) cardiac intensive care units in children following heart surgery.

scholarly journals Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Mirthe J. Mebius ◽  
Gideon J. du Marchie Sarvaas ◽  
Diana W. Wolthuis ◽  
Beatrijs Bartelds ◽  
Martin C. J. Kneyber ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infrared Spectroscopy ◽  
Case Report ◽  
Near Infrared Spectroscopy ◽  
Congenital Heart ◽  
Near Infrared ◽  
Clinical Deterioration

Prognostic Value of Perioperative Near-Infrared Spectroscopy During Neonatal and Infant Congenital Heart Surgery for Adverse In-Hospital Clinical Events

2012 ◽  
Vol 3 (2) ◽  
pp. 221-228 ◽  
Author(s):  
Jannika Dodge-Khatami ◽  
Urda Gottschalk ◽  
Christine Eulenburg ◽  
Ulrike Wendt ◽  
Clivia Schnegg ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Extracorporeal Membrane Oxygenation ◽  
Near Infrared Spectroscopy ◽  
Heart Surgery ◽  
Near Infrared ◽  
Length Of Hospital Stay ◽  
Inverse Correlation ◽  
Membrane Oxygenation ◽  
Icu Stay ◽  
Lactate Levels

Background: Perioperative monitoring with multisite near-infrared spectroscopy (NIRS) for congenital cardiac surgery with cardiopulmonary bypass may aid in predicting adverse clinical outcomes. Methods: Forty-one consecutive neonates and infants undergoing bypass were monitored with right + left cerebral and renal NIRS. Near-infrared spectroscopy and lactate were measured at 20 time points, from baseline 1 day preoperatively, during bypass and modified ultrafiltration (MUF; 10 minutes), until 24 hours postoperatively. Adverse events were extracorporeal membrane oxygenation (ECMO)/death, prolonged intensive care unit (ICU) or length of hospital stay. Results: Perioperative mean renal NIRS remained higher than baseline (n = 41) as did cerebral NIRS in all undergoing biventricular repair. During bypass (n = 41), mean right and left cerebral NIRS were equal. During MUF, cerebral and renal NIRS values increased ( P < .001). Cerebral NIRS and lactate inversely correlated during the first six postoperative hours. Extracorporeal membrane oxygenation /death occurred in four patients, correlating with cerebral and renal NIRS below 45% ( P = .030) and 40% ( P = .019) at anytime, respectively, and with mean lactate levels >9.3 mmol/L in the first postoperative 24 hours ( P < .001). Among survivors, renal NIRS below 30% at any time predicted a longer ICU stay. Conclusions: At bypass conclusion, 10 minutes of MUF does not adversely affect cerebral or renal NIRS. Left and right cerebral NIRS are equal, so that biparietal cerebral NIRS monitoring is probably not warranted. Perioperative cerebral and renal NIRS readings, respectively, below 45% and 40% correlate with ECMO/death and renal NIRS below 30% with prolonged ICU stay. Cerebral NIRS and lactate levels showed a strong inverse correlation during the first six postoperative hours.

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