title: Near-infrared spectroscopy correlates with continuous superior vena cava oxygen saturation in pediatric cardiac surgery patients.
abstract: BACKGROUND
  Cerebral regional oxygen saturation (rSO(2)) measured with near-infrared spectroscopy (NIRS) has a well-proven clinical utility. A goal-oriented treatment based on the rSO(2) resulted in a significant reduction in major morbidity and in a shortening of postoperative hospital stay in patients undergoing coronary revascularization. In this study, we have compared the values of superior vena cava saturation (ScvO(2)) continuously measured with a Pediasat catheter and the corresponding NIRS rSO(2) values obtained during cardiac operations in pediatric patients.
  
  
  METHODS
  This was a prospective observational study enrolling fifteen pediatric patients (age: 6 days-7 years) undergoing cardiac operations. ScvO(2) data obtained with the Pediasat during the operation were compared with simultaneously recorded NIRS rSO(2) values.
  
  
  RESULTS
  One hundred and seventeen matched sets of data were obtained during the operation. ScvO(2) continuously measured with the Pediasat was significantly correlated with the corresponding NIRS rSO(2) values. However, there was a constant positive bias (ScvO(2) values were higher than NIRS rSO(2) values) of 5.6%, with a precision of 10.4%. Time-related percentage changes of NIRS rSO(2) were significantly correlated with the corresponding ScvO(2) percentage changes. A decrease in ScvO(2) is predictive for a decrease in rSO(2) with a sensitivity of 73.7% and a specificity of 85.7%.
  
  
  CONCLUSIONS
  The continuous measurement of ScvO(2) values obtained by the Pediasat may provide useful information about the metabolic conditions of the brain during cardiac operations in pediatric patients if considered as percentage changes. Absolute values of ScvO(2) tend to overestimate the correspondent rSO(2) values.
authors.affiliation: Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico S.Donato, Milan, Italy. cardioanestesia@virgilio.it
authors.forename: Marco
authors.initials: M
authors.lastname: Ranucci
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Isgrò
authors.forename: Teresa
authors.initials: T
authors.lastname: De la Torre
authors.forename: Federica
authors.initials: F
authors.lastname: Romitti
authors.forename: Daniela
authors.initials: D
authors.lastname: Conti
authors.forename: Concetta
authors.initials: C
authors.lastname: Carlucci
mesh_terms: D001923:Brain Chemistry; D002138:Calibration; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D010092:Oximetry; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D014683:Vena Cava, Superior / Q000502:physiology*
chemical_list: D010100:Oxygen