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Noninvasive Cerebral Oximeter as a Surrogate for Mixed Venous Saturation in Children

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Abstract

We evaluated the relationship between regional cerebral oxygen saturation (rSO2) measured by near-infrared spectroscopy (NIRS) cerebral oximeter with superior vena cava (SVC), inferior vena cava (IVC), right atrium (RA), and pulmonary artery (PA) saturation measured on room air and 100% inspired oxygen administered via a non-rebreather mask (NRB) in children. Twenty nine pediatric post-orthotopic heart transplant patients undergoing an annual myocardial biopsy were studied. We found a statistically significant correlation between rSO2 and SVC saturations at room air and 100% inspired oxygen concentration via NRB (r = 0.67, p = 0.0002 on room air; r = 0.44, p = 0.02 on NRB), RA saturation (r = 0.56, p = 0.002; r = 0.56, p = 0.002), and PA saturation (r = 0.67, p < 0.001; r = 0.4, p = 0.03). A significant correlation also existed between rSO2 and measured cardiac index (r = 0.45, p = 0.01) and hemoglobin levels (r = 0.41, p = 0.02). The concordance correlations were fair to moderate. Bias and precision of rSO2 compared to PA saturations on room air were −0.8 and 13.9%, and they were 2.1 and 15.6% on NRB. A stepwise linear regression analysis showed that rSO2 saturations were the best predictor of PA saturations on both room air (p = 0.0001) and NRB (p = 0.012). In children with biventricular anatomy, rSO2 readings do correlate with mixed venous saturation.

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Acknowledgment

This work was supported by the University of Arkansas for Medical Sciences College of Medicine Dean’s CUMG/Research Development Fund Grant Program.

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Authors and Affiliations

  1. Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, AR, 72202, USA

    Adnan T. Bhutta, Jesse W. Ford, James G. Parker, Parthak Prodhan, Eudice E. Fontenot, Paul M. Seib, Brittany I. Stroope, Elizabeth A. Frazier & William R. Morrow

  2. Department of Anesthesiology, University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, AR, 72202, USA

    Michael L. Schmitz

  3. Department of Surgery, University of Arkansas for Medical Sciences and Arkansas Children’s Hospital, Little Rock, AR, 72202, USA

    Jonathan J. Drummond-Webb

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  1. Adnan T. Bhutta
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  2. Jesse W. Ford
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Correspondence to Adnan T. Bhutta.

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Bhutta, A.T., Ford, J.W., Parker, J.G. et al. Noninvasive Cerebral Oximeter as a Surrogate for Mixed Venous Saturation in Children. Pediatr Cardiol 28, 34–41 (2007). https://doi.org/10.1007/s00246-006-1379-z

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  • DOI: https://doi.org/10.1007/s00246-006-1379-z

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