Evaluation of pediatric near-infrared cerebral oximeter for cardiac disease

Renee N. Kreeger, Chandra Ramamoorthy, Susan C. Nicolson, Warwick A. Ames, Russel Hirsch, Lynn F. Peng, Andrew C. Glatz, Kevin D. Hill, Joan Hoffman, Jon Tomasson, C. Dean Kurth

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

Background: Cerebral hypoxia-ischemia remains a complication in children with congenital heart disease. Near-infrared spectroscopy can be utilized at the bedside to detect cerebral hypoxia-ischemia. This study aimed to calibrate and validate an advanced technology near-infrared cerebral oximeter for use in children with congenital heart disease. Methods: After institutional review board approval and parental consent, 100 children less than 12 years and less than 40 kg were enrolled. Phase I (calibration) measured arterial and jugular venous saturation (SaO2, SjO2) by co-oximetry simultaneously with device signals to calibrate an algorithm to determine regional cerebral saturation against a weighted average cerebral saturation (0.7 SjO2 + 0.3 SaO2). Phase II (validation) evaluated regional cerebral saturation from the algorithm against the weighted average cerebral saturation by correlation, bias, precision, and A Root Mean Square assessed by linear regression and Bland-Altman analysis. Results: Of 100 patients, 86 were evaluable consisting of 7 neonates, 44 infants, and 35 children of whom 55% were female, 79% Caucasian, and 41% with cyanotic disease. The SaO2 and regional cerebral saturation ranged from 34% to 100% and 34% to 91%, respectively. There were no significant differences in subject characteristics between phases. For the entire cohort, ARMS, bias, precision, and correlation coefficient were 5.4%, 0.5%, 5.39%, and 0.88, respectively. Age, skin color, and hematocrit did not affect these values. Conclusions: This cerebral oximeter accurately measures the absolute value of cerebral saturation in children over a wide range of oxygenation and subject characteristics, offering advantages in assessment of cerebral hypoxia-ischemia in congenital heart disease.

Original languageEnglish
Pages (from-to)1527-1533
Number of pages7
JournalAnnals of Thoracic Surgery
Volume94
Issue number5
DOIs
StatePublished - Nov 2012

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