title: Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease.
abstract: Some infants with congenital heart disease are at risk of in-hospital cardiac arrest. To better foresee cardiac arrest in infants with congenital heart disease, it might be useful to continuously assess end-organ perfusion. Near-infrared spectroscopy is a non-invasive method to continuously assess multisite regional tissue oxygen saturation.
  
  
  
  We report on two infants with duct-dependent congenital heart disease who demonstrated a gradual change in cerebral and/or renal tissue oxygen saturation before cardiopulmonary resuscitation was required. In both cases, other clinical parameters such as heart rate, arterial oxygen saturation and blood pressure did not indicate that deterioration was imminent.
  
  
  
  These two cases demonstrate that near-infrared spectroscopy might contribute to detecting a deteriorating clinical condition and might therefore be helpful in averting cardiopulmonary collapse and need for resuscitation in infants with congenital heart disease.
authors.affiliation: University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands. m.j.mebius01@umcg.nl.
authors.forename: Mirthe J
authors.initials: MJ
authors.lastname: Mebius
authors.affiliation: University Medical Center Groningen, Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands.
authors.forename: Gideon J
authors.initials: GJ
authors.lastname: du Marchie Sarvaas
authors.affiliation: University Medical Center Groningen, Beatrix Children's Hospital, Division of Pediatric Intensive Care, University of Groningen, Groningen, The Netherlands.
authors.forename: Diana W
authors.initials: DW
authors.lastname: Wolthuis
authors.affiliation: University Medical Center Groningen, Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands.
authors.forename: Beatrijs
authors.initials: B
authors.lastname: Bartelds
authors.affiliation: University Medical Center Groningen, Beatrix Children's Hospital, Division of Pediatric Intensive Care, University of Groningen, Groningen, The Netherlands.|Critical Care, Anesthesiology, Peri-operative & Emergency medicine (CAPE), the University of Groningen, Groningen, The Netherlands.
authors.forename: Martin C J
authors.initials: MCJ
authors.lastname: Kneyber
authors.affiliation: University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
authors.affiliation: University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
authors.forename: Elisabeth M W
authors.initials: EMW
authors.lastname: Kooi
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001921:Brain / Q000378:metabolism; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D006330:Heart Defects, Congenital / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000378:metabolism; D008297:Male; D010100:Oxygen / Q000378:metabolism*; D019265:Spectroscopy, Near-Infrared
chemical_list: D015415:Biomarkers; D010100:Oxygen
keywords: Cardiac arrest; Cardiopulmonary resuscitation; Case report; Congenital heart disease; Intensive care; Near-infrared spectroscopy; Newborn infants