title: Near-infrared spectroscopy after high-risk congenital heart surgery in the paediatric intensive care unit.
abstract: OBJECTIVE
  To establish whether the use of near-infrared spectroscopy is potentially beneficial in high-risk cardiac infants in United Kingdom paediatric intensive care units.
  
  
  METHODS
  A prospective observational pilot study.
  
  
  METHODS
  An intensive care unit in North West England.
  
  
  METHODS
  A total of 10 infants after congenital heart surgery, five with biventricular repairs and five with single-ventricle physiology undergoing palliation.
  
  
  METHODS
  Cerebral and somatic near-infrared spectroscopy monitoring for 24 hours post-operatively in the intensive care unit.
  
  
  RESULTS
  Overall, there was no strong correlation between cerebral near-infrared spectroscopy and mixed venous oxygen saturation (r=0.48). At individual time points, the correlation was only strong (r=0.74) 1 hour after admission. The correlation was stronger for the biventricular patients (r=0.68) than single-ventricle infants (r=0.31). A strong inverse correlation was demonstrated between cerebral near-infrared spectroscopy and serum lactate at 3 of the 5 post-operative time points (1, 4, and 12 hours: r=-0.76, -0.72, and -0.69). The correlation was stronger when the cerebral near-infrared spectroscopy was <60%. For cerebral near-infrared spectroscopy <60%, the inverse correlation with lactate was r=-0.82 compared with those cerebral near-infrared spectroscopy >60%, which was r=-0.50. No correlations could be demonstrated between (average) somatic near-infrared spectroscopy and serum lactate (r=-0.13, n=110) or mixed venous oxygen saturation and serum lactate. There was one infant who suffered a cardiopulmonary arrest, and the cerebral near-infrared spectroscopy showed a consistent 43 minute decline before the event.
  
  
  CONCLUSIONS
  We found that cerebral near-infrared spectroscopy is potentially beneficial as a non-invasive, continuously displayed value and is feasible to use on cost-constrained (National Health Service) cardiac intensive care units in children following heart surgery.
authors: 1Department of PICU,Alder Hey Children's NHS Foundation Trust and Department,Liverpool,United Kingdom.
authors: Lyvonne N
authors: LN
authors: Tume
authors: 3Department of Translational Medicine,Alder Hey Children's NHS Foundation Trust,University of Liverpool,Liverpool,United Kingdom.
authors: Philip
authors: P
authors: Arnold
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D004739:England; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D064887:Observational Studies as Topic; D010100:Oxygen / Q000097:blood*; D011184:Postoperative Period; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared
chemical_list: D019344:Lactic Acid; D010100:Oxygen
keywords: monitoring