Purpose
Near-infrared spectroscopy (NIRS) and continuous
central venous oxygen saturation (ScvO
2) via oximetry
catheter are 2 modalities available to estimate adequacy of oxygen delivery in postoperative pediatric cardiac patients. Near-infrared spectroscopy measures regional tissue oxygenation and is routinely used in pediatric cardiac surgery patients. By not requiring an invasive
catheter, NIRS has the advantage over mixed
venous oxygen saturation (SvO
2) monitoring. An alternative marker of global tissue oxygenation is
central venous oxygen saturation (ScvO
2). A recently developed pediatric-sized oximetric
catheter (PediaSat; Edwards Lifesciences, Irvine, CA, USA) functions as a
central venous catheter and provides a continuous ScvO
2 reading, an accepted surrogate to SvO
2. To date, the correlation between NIRS and ScvO
2 has not been quantified. The aim of this study was to examine the strength of the bivariate correlation between NIRS and ScvO
2 measurements.
Design/methods
Twenty pediatric patients undergoing cardiac surgery had the PediaSat catheter placed with the tip in the superior vena cava and NIRS sensors (cerebral and renal) placed in the operating room per routine protocol. Hourly measurements of NIRS-cerebral (NIRS-C), NIRS-renal, and ScvO2 readings were recorded for each patient for up to 48 hours postoperatively.
Results
A cumulative total of 630 hours of data were collected. Spearman correlation coefficients for聽NIRS-renal vs ScvO2 and NIRS-C vs ScvO2 measurements were r = 0.38 (P = .09) and r = 0.58 (P聽< .008), respectively.
Conclusions
In this small cohort of pediatric patients undergoing heart surgery, there was a moderate but statistically significant correlation between the ScvO2-catheter and the NIRS-C values. Further studies are required to determine which oxymetric modality of monitoring cardiac output most aids in the postoperative management of these patients.