In:
Pediatric Anesthesia, Wiley, Vol. 14, No. 12 ( 2004-12), p. 989-995
Abstract:
Background : The aim of the study was to compare liver tissue oxygenation determined by near infrared spectroscopy (NIRS) with central venous oxygen saturation (SvO 2 ) and intestinal perfusion as measured by gastric intramucosal pH (pHi) in pediatric surgical patients. Methods : Twenty children undergoing craniofacial surgery with expected major intraoperative blood loss were studied. NIRS tissue oxygenation index (TOI Liver ) and pHi values were recorded. Arterial blood gas analysis and SvO 2 were assessed from periodically taken blood samples. Data are presented as ranges (median) and were compared using linear regression analysis. Sensitivity and specificity of the intra‐individual changes in TOI Liver to predict falling SvO 2 or pHi values were calculated. Results : Patients age ranged from 0.79 to 8.27 years (1.92 years). TOI Liver ranged from 41.5 to 77.4% (61.5%), gastric pHi from 7.13 to 7.60 (7.37) and SvO 2 from 51 to 86% (74%). Among patients only moderate correlation was found between TOI Liver and SvO 2 ( r = 0.594, P 〈 0.0001) and gastric pH i ( r = 0.502, P 〈 0.0001). Intra‐individual measured TOI Liver values, however, demonstrated close correlation with SvO 2 values ( r = 0.680 to 0.976) but a varying correlation with gastric pHi values ( r = 0.055 to 0.972). Sensitivity/specificity of TOI Liver to predict decreasing SvO 2 or gastric pHi values were 76.4/73.4% and 67.4/62.7% respectively. Conclusions : TOI Liver provided a better trend monitor of central venous oxygen saturation than gastric intramucosal pH. Because of its limited sensitivity and specificity to indicate deterioration of SvO 2 , liver tissue oxygenation measured by transcutaneous NIRS does not provide additional practical information for clinical management.
Type of Medium:
Online Resource
ISSN:
1155-5645
,
1460-9592
DOI:
10.1111/pan.2004.14.issue-12
DOI:
10.1111/j.1460-9592.2004.01362.x
Language:
English
Publisher:
Wiley
Publication Date:
2004
detail.hit.zdb_id:
2008564-3
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