Tissue oxygenation monitoring during major pediatric surgery using transcutaneous liver near infrared spectroscopy
| Autor: | Alexander Dullenkopf, Hans U. Bucher, Anna Kolarova, Markus Weiss, Oskar Baenziger, Herrmann Sailer, Claudia M. Dillier, Ian Teller, Gabriele Schulz, Andreas C. Gerber |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Catheterization Central Venous medicine.medical_specialty Manometry Sensitivity and Specificity Craniofacial Abnormalities Blood loss Predictive Value of Tests Monitoring Intraoperative Pediatric surgery medicine Humans Arterial blood gas analysis Child Gastric tonometry Spectroscopy Near-Infrared business.industry Stomach Infant Oxygenation Hydrogen-Ion Concentration Gastric ph Oxygen Anesthesiology and Pain Medicine medicine.anatomical_structure Tissue oxygenation Liver Gastric Mucosa Child Preschool Anesthesia Pediatrics Perinatology and Child Health Linear Models Female Blood Gas Analysis Nuclear medicine business |
| Zdroj: | Pediatric Anesthesia. 14:989-995 |
| ISSN: | 1460-9592 1155-5645 |
| DOI: | 10.1111/j.1460-9592.2004.01362.x |
| Popis: | Background: The aim of the study was to compare liver tissue oxygenation determined by near infrared spectroscopy (NIRS) with central venous oxygen saturation (SvO 2 ) and intestinal perfusion as measured by gastric intramucosal pH (pHi) in pediatric surgical patients. Methods: Twenty children undergoing craniofacial surgery with expected major intraoperative blood loss were studied. NIRS tissue oxygenation index (TOI Liver ) and pHi values were recorded. Arterial blood gas analysis and SvO 2 were assessed from periodically taken blood samples. Data are presented as ranges (median) and were compared using linear regression analysis. Sensitivity and specificity of the intra-individual changes in TOI Liver to predict falling SvO 2 or pHi values were calculated. Results: Patients age ranged from 0.79 to 8.27 years (1.92 years). TOI Liver ranged from 41.5 to 77.4% (61.5%), gastric pHi from 7.13 to 7.60 (7.37) and SvO 2 from 51 to 86% (74%). Among patients only moderate correlation was found between TOI Liver and SvO 2 (r = 0.594, P < 0.0001) and gastric pH i (r = 0.502, P < 0.0001). Intra-individual measured TOI Liver values, however, demonstrated close correlation with SvO 2 values (r = 0.680 to 0.976) but a varying correlation with gastric pHi values (r = 0.055 to 0.972). Sensitivity/specificity of TOI Liver to predict decreasing SvO 2 or gastric pHi values were 76.4/73.4% and 67.4/62.7% respectively. Conclusions: TOI Liver provided a better trend monitor of central venous oxygen saturation than gastric intramucosal pH. Because of its limited sensitivity and specificity to indicate deterioration of SvO 2 , liver tissue oxygenation measured by transcutaneous NIRS does not provide additional practical information for clinical management. |
| Databáze: | OpenAIRE |
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