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Correlation of Near-Infrared Spectroscopy Oximetry and Corresponding Venous Oxygen Saturations in Children with Congenital Heart Disease

Pediatric Cardiology volume 43, pages 197–206 (2022)Cite this article

Abstract

Invasive and non-invasive monitoring allow for early detection of hemodynamic compromise, facilitating timely intervention and avoidance of further decline. While venous oximetry is useful for assessing the adequacy of systemic oxygen delivery (DO2), it is most often intermittent, invasive, and costly. Near-infrared spectroscopy (NIRS) oximetry allows for the non-invasive estimation of the adequacy of DO2. We assessed the correlation between cerebral NIRS oximetry and superior vena cava (SVC) and jugular venous (JV) oxygen saturations and between renal NIRS oximetry and inferior vena cava (IVC) oxygen saturations. Systematic review of the literature was conducted to identify studies with data regarding near-infrared spectroscopy and venous saturation. The PubMed, EMBASE, Medline, and Cochrane databases were queried using the following terms in isolation and various combinations: “congenital heart disease,” “near infrared spectroscopy,” “venous saturation,” and “pediatric.” Pediatric studies in which simultaneous NIRS oximetry and corresponding venous oxygen saturations were simultaneously collected after cardiac surgery or catheterization were identified. Data were pooled from these studies to analyze the correlation between NIRS oximetry and the corresponding venous oxygen saturations. A total of 16 studies with 613 patients were included in the final analyses. Data were present to compare cerebral and renal NIRS oximetry with corresponding venous oxygen saturation. Cerebral NIRS and SVC and JV oxygen saturations and renal NIRS and IVC oxygen saturations demonstrated strong degrees of correlation (r-value 0.70 for each). However, cerebral NIRS and IVC oxygen saturation had a week degree of correlation (r-value of 0.38). Pooled analyses demonstrate that cerebral NIRS oximetry correlates strongly with SVC or JV oxygen saturation while renal NIRS oximetry correlates strongly with IVC oxygen saturations. A weak correlation was noted between cerebral NIRS oximetry and IVC oxygen saturations.

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References

  1. Welke KF, Diggs BS, Karamlou T, Ungerleider RM (2009) Comparison of pediatric cardiac surgical mortality rates from national administrative data to contemporary clinical standards. Annal Thorac Surg 87(1):216–222. https://doi.org/10.1016/j.athoracsur.2008.10.032

    Article  Google Scholar 

  2. Bronicki RA (2011) Venous oximetry and the assessment of oxygen transport balance. Pediatr Crit Care Med 12(4):S21–S26. https://doi.org/10.1097/PCC.0b013e3182211667

    Article  PubMed  Google Scholar 

  3. Beal AL, Cerra FB (1994) Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. JAMA 271(3):226–233

    CAS  Article  Google Scholar 

  4. Rivers E, Nguyen B, Havstad S et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345(19):1368–1377. https://doi.org/10.1056/nejmoa010307

    CAS  Article  PubMed  Google Scholar 

  5. Ghanayem NS, Hoffman GM (2016) Near Infrared Spectroscopy as a Hemodynamic Monitor in Critical Illness. Pediatr Crit Care Med 17(8 1):S201–S206. https://doi.org/10.1097/pcc.0000000000000780

    Article  PubMed  Google Scholar 

  6. Tsang R, Checchia P, Bronicki RA (2016) Hemodynamic monitoring in the acute management of pediatric heart failure. Curr Cardiol Rev 12(2):112–116. https://doi.org/10.2174/1573403x12666151119165007

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rivers EP, Ander DS, Powell D (2001) Central venous oxygen saturation monitoring in the critically ill patient. Curr Opin Crit Care 7(3):204–211. https://doi.org/10.1097/00075198-200106000-00011

    CAS  Article  PubMed  Google Scholar 

  8. Pérez AC, Eulmesekian PG, Minces PG, Schnitzler EJ (2009) Adequate agreement between venous oxygen saturation in right atrium and pulmonary artery in critically ill children. Pediatr Crit Care Med 10(1):76–79. https://doi.org/10.1097/PCC.0b013e318193699d

    Article  PubMed  Google Scholar 

  9. Nagdyman N, Fleck T, Schubert S et al (2005) Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children. Intensive Care Med 31(6):846–850. https://doi.org/10.1007/s00134-005-2618-0

    Article  PubMed  Google Scholar 

  10. Abdul-Khaliq H, Troitzsch D, Berger F, Lange PE (2000) Regional transcranial oximetry with near infrared spectroscopy (NIRS) in comparison with measuring oxygen saturation in the jugular bulb in infants and children for monitoring cerebral oxygenation. Biomed Tech (Berl), 45(11):328–32. Regionale transkranielle Oxymetrie mit Nahinfrarot-Spektroskopie (NIRS) im Vergleich zur Messung der Sauerstoffsättigung im Bulbus jugularis bei Säuglingen und Kindern als Monitoring der zerebralen Oxygenierung. https://doi.org/10.1515/bmte.2000.45.11.328

  11. Hoffman GM, Ghanayem NS, Scott JP, Tweddell JS, Mitchell ME, Mussatto KA (2017) Postoperative cerebral and somatic near-infrared spectroscopy saturations and outcome in hypoplastic left heart syndrome. Ann Thorac Surg 103(5):1527–1535. https://doi.org/10.1016/j.athoracsur.2016.09.100

    Article  PubMed  Google Scholar 

  12. Scott JP, Hoffman GM (2014) Near-infrared spectroscopy: exposing the dark (venous) side of the circulation. Paediatr Anaesth 24(1):74–88. https://doi.org/10.1111/pan.12301

    Article  PubMed  Google Scholar 

  13. Kreeger RN, Ramamoorthy C, Nicolson SC et al (2012) Evaluation of pediatric near-infrared cerebral oximeter for cardiac disease. Ann Thorac Surg 94(5):1527–1533. https://doi.org/10.1016/j.athoracsur.2012.05.096

    Article  PubMed  Google Scholar 

  14. Bronicki RA, Checchia PA, Anas NG et al (2013) Cerebral and somatic oxygen saturations after repair of tetralogy of Fallot: effects of extubation on regional blood flow. Ann Thorac Surg 95(2):682–686. https://doi.org/10.1016/j.athoracsur.2012.07.017

    Article  PubMed  Google Scholar 

  15. Bronicki RA, Herrera M, Mink R et al (2010) Hemodynamics and cerebral oxygenation following repair of tetralogy of Fallot: the effects of converting from positive pressure ventilation to spontaneous breathing. Congenit Heart Dis 5(5):416–421. https://doi.org/10.1111/j.1747-0803.2010.00445.x

    Article  PubMed  Google Scholar 

  16. Altun D, Doğan A, Arnaz A et al (2020) Noninvasive monitoring of central venous oxygen saturation by jugular transcutaneous near-infrared spectroscopy in pediatric patients undergoing congenital cardiac surgery. Turk J Med Sci 50(5):1280–1287. https://doi.org/10.3906/sag-1911-135

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  17. Bhutta AT, Ford JW, Parker JG et al (2007) Noninvasive cerebral oximeter as a surrogate for mixed venous saturation in children. Pediatr Cardiol 28(1):34–41. https://doi.org/10.1007/s00246-006-1379-z

    Article  PubMed  Google Scholar 

  18. Dabal RJ, Rhodes LA, Borasino S, Law MA, Robert SM, Alten JA (2013) Inferior vena cava oxygen saturation monitoring after the Norwood procedure. Ann Thorac Surg 95(6):2114–2120. https://doi.org/10.1016/j.athoracsur.2013.01.076

    Article  PubMed  Google Scholar 

  19. Daubeney PE, Pilkington SN, Janke E, Charlton GA, Smith DC, Webber SA (1996) Cerebral oxygenation measured by near-infrared spectroscopy: comparison with jugular bulb oximetry. Ann Thorac Surg 61(3):930–934. https://doi.org/10.1016/0003-4975(95)01186-2

    CAS  Article  PubMed  Google Scholar 

  20. Gagnon MH, Kussman BD, Zhou L, DiNardo JA, Kheir JN (2020) Sensitivity of a next-generation NIRS device to detect low mixed venous oxyhemoglobin saturations in the single ventricle population. Anesth Analg 131(3):e138–e141. https://doi.org/10.1213/ane.0000000000004580

    Article  PubMed  Google Scholar 

  21. Gil-Anton J, Redondo S, Garcia Urabayen D, Nieto Faza M, Sanz I, Pilar J (2015) Combined cerebral and renal near-infrared spectroscopy after congenital heart surgery. Pediatr Cardiol 36(6):1173–1178. https://doi.org/10.1007/s00246-015-1139-z

    Article  PubMed  Google Scholar 

  22. Ginther R, Sebastian VA, Huang R et al (2011) Cerebral near-infrared spectroscopy during cardiopulmonary bypass predicts superior vena cava oxygen saturation. J Thorac Cardiovasc Surg 142(2):359–365. https://doi.org/10.1016/j.jtcvs.2010.12.021

    Article  PubMed  Google Scholar 

  23. Hansen JH, Schlangen J, Armbrust S, Jung O, Scheewe J, Kramer HH (2013) Monitoring of regional tissue oxygenation with near-infrared spectroscopy during the early postoperative course after superior cavopulmonary anastomosis. Eur J Cardiothorac Surg 43(2):e37-43. https://doi.org/10.1093/ejcts/ezs581

    Article  PubMed  Google Scholar 

  24. Knirsch W, Stutz K, Kretschmar O et al (2008) Regional cerebral oxygenation by NIRS does not correlate with central or jugular venous oxygen saturation during interventional catheterisation in children. Acta Anaesthesiol Scand 52(10):1370–1374. https://doi.org/10.1111/j.1399-6576.2008.01703.x

    CAS  Article  PubMed  Google Scholar 

  25. Marimón GA, Dockery WK, Sheridan MJ, Agarwal S (2012) Near-infrared spectroscopy cerebral and somatic (renal) oxygen saturation correlation to continuous venous oxygen saturation via intravenous oximetry catheter. J Crit Care 27(3):314.e13–8. https://doi.org/10.1016/j.jcrc.2011.10.002

    Article  Google Scholar 

  26. Nagdyman N, Ewert P, Peters B, Miera O, Fleck T, Berger F (2008) Comparison of different near-infrared spectroscopic cerebral oxygenation indices with central venous and jugular venous oxygenation saturation in children. Paediatr Anaesth 18(2):160–166. https://doi.org/10.1111/j.1460-9592.2007.02365.x

    Article  PubMed  Google Scholar 

  27. Nasr VG, Bergersen LT, Lin HM et al (2019) Validation of a second-generation near-infrared spectroscopy monitor in children with congenital heart disease. Anesth Analg 128(4):661–668. https://doi.org/10.1213/ane.0000000000002796

    CAS  Article  PubMed  Google Scholar 

  28. Ortmann LA, Fontenot EE, Seib PM, Eble BK, Brown R, Bhutta AT (2011) Use of near-infrared spectroscopy for estimation of renal oxygenation in children with heart disease. Pediatr Cardiol 32(6):748–753. https://doi.org/10.1007/s00246-011-9960-5

    Article  PubMed  Google Scholar 

  29. Ranucci M, Isgrò G, De la Torre T, Romitti F, Conti D, Carlucci C (2008) Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients. Paediatr Anaesth 18(12):1163–1169. https://doi.org/10.1111/j.1460-9592.2008.02783.x

    Article  PubMed  Google Scholar 

  30. Rescoe E, Tang X, Perry DA et al (2017) Cerebral near-infrared spectroscopy insensitively detects low cerebral venous oxygen saturations after stage 1 palliation. J Thorac Cardiovasc Surg 154(3):1056–1062. https://doi.org/10.1016/j.jtcvs.2017.03.154

    Article  PubMed  Google Scholar 

  31. Ricci Z, Garisto C, Favia I et al (2010) Cerebral NIRS as a marker of superior vena cava oxygen saturation in neonates with congenital heart disease. Paediatr Anaesth 20(11):1040–1045. https://doi.org/10.1111/j.1460-9592.2010.03430.x

    Article  PubMed  Google Scholar 

  32. Ranucci M, Isgro G, Carlucci C et al (2010) Central venous oxygen saturation and blood lactate levels during cardiopulmonary bypass are associated with outcome after pediatric cardiac surgery. Crit Care 14(4):R149. https://doi.org/10.1186/cc9217

    Article  PubMed  PubMed Central  Google Scholar 

  33. Hoffman GM, Ghanayem NS, Kampine JM et al (2000) Venous saturation and the anaerobic threshold in neonates after the Norwood procedure for hypoplastic left heart syndrome. Annal Thorac Surg 70(5):1515–1520. https://doi.org/10.1016/s0003-4975(00)01772-0

    CAS  Article  Google Scholar 

  34. Tweddell JS, Hoffman GM, Mussatto KA et al (2002) Improved survival of patients undergoing palliation of hypoplastic left heart syndrome: lessons learned from 115 consecutive patients. Circulation 106(12 Suppl 1):I82–I89

    PubMed  Google Scholar 

  35. Tweddell JS, Ghanayem NS, Mussatto KA et al (2007) Mixed venous oxygen saturation monitoring after stage 1 palliation for hypoplastic left heart syndrome. Annal Thorac Surg 84(4):1301–1310. https://doi.org/10.1016/j.athoracsur.2007.05.047

    Article  Google Scholar 

  36. Ranucci M, Isgro G, De La Torre T et al (2008) Continuous monitoring of central venous oxygen saturation (Pediasat) in pediatric patients undergoing cardiac surgery: a validation study of a new technology. J Cardiothorac Vasc Anesth 22(6):847–852. https://doi.org/10.1053/j.jvca.2008.04.003

    Article  PubMed  Google Scholar 

  37. Goldman SM, Sutter FP, Wertan MA, Ferdinand FD, Trace CL, Samuels LE (2006) Outcome improvement and cost reduction in an increasingly morbid cardiac surgery population. Seminars in cardiothoracic and vascular anesthesia 10(2):171–175. https://doi.org/10.1177/1089253206289009

    Article  PubMed  Google Scholar 

  38. Madsen PL, Skak C, Rasmussen A, Secher NH (2000) Interference of cerebral near-infrared oximetry in patients with icterus. Anesth Analg 90(2):489–493. https://doi.org/10.1097/00000539-200002000-00046

    CAS  Article  PubMed  Google Scholar 

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Acknowledgements

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Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Cardiology, Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA

    Rohit S. Loomba & Jacqueline Rausa

  2. Medicine, Chicago Medical School/Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA

    Rohit S. Loomba, Danielle Sheikholeslami & Aaron E. Dyson

  3. Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo Leon, Mexico

    Juan S. Farias & Enrique G. Villarreal

  4. Division of Critical Care, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA

    Saul Flores & Ronald A. Bronicki

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  1. Rohit S. Loomba
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  4. Aaron E. Dyson
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  8. Ronald A. Bronicki
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Contributions

RSL, SF, and JR contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JSF, EGV, DS, and AD. The first draft of the manuscript was written by RSL, JSF, SF, and JR commented on previous versions of the manuscript. All authors read and approved the final manuscript. Reviewing and editing was done by RAB and EGV.

Corresponding author

Correspondence to Enrique G. Villarreal.

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The Study has been approved by the appropriate institutional ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Loomba, R.S., Rausa, J., Sheikholeslami, D. et al. Correlation of Near-Infrared Spectroscopy Oximetry and Corresponding Venous Oxygen Saturations in Children with Congenital Heart Disease. Pediatr Cardiol 43, 197–206 (2022). https://doi.org/10.1007/s00246-021-02718-7

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  • DOI: https://doi.org/10.1007/s00246-021-02718-7

Keywords

  • Near-infrared spectroscopy
  • Oximetry
  • Congenital heart defects
  • Critical care
  • Pediatrics