title: Regional venous oxygen saturation versus mixed venous saturation after paediatric cardiac surgery.
abstract: BACKGROUND
  Central venous oxygen saturation (ScvO2) remains the gold standard surrogate for tissue oxygen extraction in paediatric cardiac surgery. Near-infrared spectroscopy (NIRS) has been developed as a non-invasive diagnostic tool for regional oxygen saturation. The aim was to compare regional oxygen saturation measured by NIRS with ScvO2 in postoperative paediatric cardiac patients.
  
  
  METHODS
  In this prospective study, we included newborns and infants younger than 45 days undergoing heart surgery. We recorded continuous ScvO2 and NIRS regional saturation placed on the forehead (B) and right flank (S) for 48 h postoperatively. A Bland-Altman's analysis was used to assess the agreement between these measurements.
  
  
  RESULTS
  A total of 23 patients were included with a median age of 12 days (2-46) and median weight of 3.1 kg (2.3-4.47). The mean difference (MD) ScvO2- B NIRS was 10.45% with limits of agreement (LOA) -17.23 to 38.13% and ScvO2- S NIRS MD 7.16% with LOA: -25.51 to 39.84%. The single ventricle ScvO2- S NIRS subgroup had MD within ± 5%; however, wide LOA was observed. The remaining subgroups showed MD nearly above ± 5%, with wide LOA.
  
  
  CONCLUSIONS
  The regional oxygen saturation of brain and kidney did not match ScvO2 as estimation of global tissue perfusion. Nevertheless, NIRS may still provide information regarding regional circulation that may help in the management of neonatal cardiac surgery patients.
authors.affiliation: Cardiac Intensive Care Unit (UCI35), Hospital de Pediatría Dr Juan P. Garrahan, Ciudad Autónoma de Buenos Aires, Argentina. guillermo.moreno1@gmail.com
authors.forename: G E
authors.initials: GE
authors.lastname: Moreno
authors.forename: M L
authors.initials: ML
authors.lastname: Pilán
authors.forename: C
authors.initials: C
authors.lastname: Manara
authors.forename: R
authors.initials: R
authors.lastname: Magliola
authors.forename: J C
authors.initials: JC
authors.lastname: Vassallo
authors.forename: M
authors.initials: M
authors.lastname: Balestrini
authors.forename: A M
authors.initials: AM
authors.lastname: Lenz
authors.forename: M
authors.initials: M
authors.lastname: Krynski
authors.forename: M
authors.initials: M
authors.lastname: Althabe
authors.forename: L
authors.initials: L
authors.lastname: Landry
mesh_terms: D001145:Arrhythmias, Cardiac / Q000175:diagnosis; D001784:Blood Gas Analysis / Q000379:methods; D002303:Cardiac Output, Low / Q000175:diagnosis; D006348:Cardiac Surgical Procedures; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006352:Heart Ventricles / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D007022:Hypotension / Q000175:diagnosis; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen