Application of near-infrared spectroscopy during fetal cardiac surgery

Casey A. Reed, R. Scott Baker, Christopher T. Lam, Jerri L. Hilshorst, Robert Ferguson, John Lombardi, Pirooz Eghtesady

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

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. Materials and 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.

Original languageEnglish
Pages (from-to)159-163
Number of pages5
JournalJournal of Surgical Research
Volume171
Issue number1
DOIs
StatePublished - Nov 2011

Keywords

  • animal model
  • cardiopulmonary bypass (CPB)
  • fetal intervention
  • near infrared spectroscopy
  • regional oxygen saturation

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