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Renal Oximetry in Neonates and Children During Cardiac Surgery

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Abstract

In neonates and children undergoing cardiac surgery, assessment of the microcirculation is increasingly recognized as being important for optimal care. Conventional hemodynamic monitoring techniques do not allow assessment of the microcirculation. Assessment of the renal microcirculation is further complicated due to its dependency on the macrocirculation, organ-specific autoregulatory mechanisms, and interactions with other organs. NIRS (near-infrared spectroscopy) is noninvasive technology increasingly used in the operative and critical care environments to assess regional oxygen supply-demand balance. The NIRS oximeter measures regional changes in oxygenated and deoxygenated hemoglobin in the tissue under the probe which emits two different wavelengths of near-infrared light (730 and 810 nm), corresponding to the different spectral absorptions of oxygenated and deoxygenated hemoglobin. Measuring the quantity of returning light of each wavelength allows for the assessment of changes in the concentration of these molecules and the measured value represents the oxygen content in the local tissue bed. NIRS has been studied extensively in animals, including models of renal ischemia and reperfusion, and is widely used for monitoring brain oxygenation in neonates. More recently, it is being used to continuously visualize, by a probe placed on the flank, renal microcirculation disturbance in neonates and young children, particularly in pediatric cardiac intensive care units and during cardiac surgery.

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Correspondence to Catherine Jane Morgan .

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Morgan, C.J. (2021). Renal Oximetry in Neonates and Children During Cardiac Surgery. In: Sethi, S.K., Raina, R., McCulloch, M., Bunchman, T.E. (eds) Advances in Critical Care Pediatric Nephrology. Springer, Singapore. https://doi.org/10.1007/978-981-33-4554-6_11

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  • DOI: https://doi.org/10.1007/978-981-33-4554-6_11

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-33-4553-9

  • Online ISBN: 978-981-33-4554-6

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