Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children
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- Nagdyman, N., Fleck, T., Schubert, S. et al. Intensive Care Med (2005) 31: 846. doi:10.1007/s00134-005-2618-0
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To compare the cerebral tissue oxygenation index (TOI) measured by near-infrared spectroscopy (NIRS) with venous oxygen saturation in the jugular bulb (SjO2) during elective cardiac catheterization in children.
Design and setting
Prospective observational clinical study in a catheterization laboratory for pediatric cardiology.
Sixty children with congenital heart defects admitted to the catheterization laboratory.
Measurements and results
TOI measured noninvasively by NIRS was compared to SjO2 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 SjO2 (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 SjO2.