title: Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children.
abstract: OBJECTIVE
  To compare the cerebral tissue oxygenation index (TOI) measured by near-infrared spectroscopy (NIRS) with venous oxygen saturation in the jugular bulb (SjO(2)) during elective cardiac catheterization in children.
  
  
  METHODS
  Prospective observational clinical study in a catheterization laboratory for pediatric cardiology.
  
  
  METHODS
  Sixty children with congenital heart defects admitted to the catheterization laboratory.
  
  
  RESULTS
  TOI measured noninvasively by NIRS was compared to SjO(2) measured in the jugular bulb during cardiac catheterization. Patients were divided into two groups regarding body weight: below (n=29) and above 10 kg (n=31). Linear regression analysis and Pearson's correlation coefficient were calculated. Bland-Altman analysis, sensitivity, and specificity calculation for spatially resolved near-infrared spectroscopy with a cutoff level of 60% were performed. Simultaneously measured values for SjO(2) (67.3+/-9.8%, 40-84.1%) and TOI (65.7+/-7.2%, 39-80%) showed a significant correlation; the correlation in children weighing under 10 kg was stronger in children weighing over 10 kg. Bland-Altman analysis showed a mean bias of -1.8% with limits of agreement between 11.7% and -15.3% for all children. Sensitivity and specificity of the SRS method were 46% and 91%, respectively, for all children and 53% and 83% respectively in infants weighing under 10 kg.
  
  
  CONCLUSIONS
  The results demonstrate that despite a significant correlation, sensitivity of spatially resolved spectroscopy is poor, and it is questionable whether TOI can be used reliably to detect low SjO(2).
authors.affiliation: Department of Congenital Heart Defects and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. nagdyman@dhzb.de
authors.forename: Nicole
authors.initials: N
authors.lastname: Nagdyman
authors.forename: Thilo
authors.initials: T
authors.lastname: Fleck
authors.forename: Stephan
authors.initials: S
authors.lastname: Schubert
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.forename: Björn
authors.initials: B
authors.lastname: Peters
authors.forename: Peter E
authors.initials: PE
authors.lastname: Lange
authors.forename: Hashim
authors.initials: H
authors.lastname: Abdul-Khaliq
mesh_terms: D000293:Adolescent; D001921:Brain / Q000098:blood supply*; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D003490:Cyanosis; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D007601:Jugular Veins / Q000378:metabolism; D016014:Linear Models; D008297:Male; D019370:Observation; D010092:Oximetry / Q000379:methods*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared