Correlation of abdominal site near-infrared spectroscopy with gastric tonometry in infants following surgery for congenital heart disease.
OBJECTIVE
Splanchnic oximetry, as measured by near-infrared spectroscopy (NIRS), correlates with gastric tonometry as a means of assessing regional (splanchnic) oxygenation and perfusion.


METHODS
Prospective, data-gathering study.


METHODS
Pediatric cardiac intensive care unit in a tertiary care children's hospital.


METHODS
Neonates and infants with congenital heart disease who underwent catheter intervention or surgical repair requiring cardiopulmonary bypass.


METHODS
None.


RESULTS
Twenty neonates and infants were studied within 48 hrs of surgery. We measured somatic saturation (rSO2) via NIRS sensors placed over the anterior abdomen (splanchnic bed) and dorsal lateral flank (renal bed). Somatic rSO2 readings were paired with simultaneous points of intramucosal gastric pH (pHi), measured by tonometry. The rSO2 readings were paired with serum lactate and measurements of systemic mixed venous saturation (SVO2). There was strong correlation between the abdominal rSO2 and pHi (r = .79; p < .0001) as well as between abdominal rSO2 and SVO2 (r = .89; p < .0001). There was also significant negative correlation between the abdominal rSO2 and serum lactate (r = .77; p < .0001). Correlations between the dorsal lateral (renal) rSO2 measurements and serum lactate and SVO2 were also significant but not as strong.


CONCLUSIONS
Abdominal site rSO2, measured in infants with either single or biventricular physiology, exhibits a strong correlation with gastric pHi as well as with serum lactate and SVO2. The results indicate that rSO2 measurements over the anterior abdominal wall correlate more strongly than flank rSO2 with regard to systemic indices of oxygenation and perfusion. This study suggests that the NIRS monitor is a valid modality to obtain an easy, immediate, and noninvasive measurement of splanchnic rSO2 in infants following cardiac surgery for congenital heart disease.
Kaufman
Jon
J
Department of Pediatrics and Division of Cardiology, The Children's Hospital, Aurora, CO 80045, USA. kaufman.jonathan@tchden.org
Almodovar
Melvin C
MC
Zuk
Jeannie
J
Friesen
Robert H
RH
D000005:Abdomen; D006330:Heart Defects, Congenital / Q000601:surgery*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008365:Manometry; D010101:Oxygen Consumption; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared; D013152:Splanchnic Circulation