Application of near-infrared spectroscopy during fetal cardiac surgery.
BACKGROUND
Near-infrared spectroscopy (NIRS) has been shown to provide reliable noninvasive monitoring of regional oxygenation in a variety of clinical settings. We set out to test its feasibility as a monitor of fetal and placental oxygenation during fetal cardiac surgery.


METHODS
Six ovine fetuses from 98-110 ds gestation were placed on fetal bypass for 30 min and followed post-bypass for 2 h. A NIRS probe (MI INVOS 5100B; Somanetics, Troy, MI) was placed on the pregnant uterine horn during and after fetal surgery. NIRS values were compared with blood gas values obtained by direct sampling from umbilical circulation.


RESULTS
NIRS values positively correlated with umbilical venous oxygen saturation (R(2)=0.891, P<0.01) and partial oxygen pressure values (R(2)=0.810, P<0.01). NIRS values also correlated to a lesser extent with umbilical venous pH and pCO(2), and fetal arterial pH, pO(2), and oxygen saturation.


CONCLUSIONS
This is the first report of application of NIRS in the setting of fetal surgery. NIRS permits noninvasive assessment of placental oxygen saturation and pO(2). This technology is a simple and useful tool for real-time monitoring of oxygen delivery to the fetus during maternal-fetal cardiac interventions and of overall well-being of the fetal-placental unit.
Reed
Casey A
CA
Division of Cardiothoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3032, USA.
Baker
R Scott
RS
Lam
Christopher T
CT
Hilshorst
Jerri L
JL
Ferguson
Robert
R
Lombardi
John
J
Eghtesady
Pirooz
P
D000818:Animals; D002245:Carbon Dioxide / Q000097:blood; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005240:Feasibility Studies; D005260:Female; D005323:Fetal Monitoring / Q000379:methods*; D005333:Fetus / Q000601:surgery*; D023421:Models, Animal; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D012756:Sheep; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
D002245:Carbon Dioxide; D010100:Oxygen