Change in regional (somatic) near-infrared spectroscopy is not a useful indictor of clinically detectable low cardiac output in children after surgery for congenital heart defects

Utpal S. Bhalala, Akira Nishisaki, Derrick McQueen, Geoffrey L. Bird, Wynne E. Morrison, Vinay M. Nadkarni, Meena Nathan, Joanne P. Starr

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Near-infrared spectroscopy correlation with low cardiac output has not been validated. Our objective was to determine role of splanchnic and/or renal oxygenation monitoring using near-infrared spectroscopy for detection of low cardiac output in children after surgery for congenital heart defects. DESIGN: Prospective observational study. SETTING: Pediatric intensive care unit of a tertiary care teaching hospital. PATIENTS: Children admitted to the pediatric intensive care unit after surgery for congenital heart defects. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We hypothesized that splanchnic and/or renal hypoxemia detected by near-infrared spectroscopy is a marker of low cardiac output after pediatric cardiac surgery. Patients admitted after cardiac surgery to the pediatric intensive care unit over a 10-month period underwent serial splanchnic and renal near-infrared spectroscopy measurements until extubation. Baseline near-infrared spectroscopy values were recorded in the first postoperative hour. A near-infrared spectroscopy event was a priori defined as ≥20% drop in splanchnic and/or renal oxygen saturation from baseline during any hour of the study. Low cardiac output was defined as metabolic acidosis (pH 2 mmol/L, or base excess ≤-5), oliguria (urine output

Original languageEnglish (US)
Pages (from-to)529-534
Number of pages6
JournalPediatric Critical Care Medicine
Volume13
Issue number5
DOIs
StatePublished - Sep 2012
Externally publishedYes

Fingerprint

Low Cardiac Output
Near-Infrared Spectroscopy
Congenital Heart Defects
Viscera
Pediatric Intensive Care Units
Kidney
Thoracic Surgery
Oliguria
Tertiary Healthcare
Acidosis
Teaching Hospitals
Observational Studies
Urine
Prospective Studies
Pediatrics
Oxygen

Keywords

  • cardiac surgery
  • cardiopulmonary bypass
  • congenital heart defect
  • low cardiac output syndrome
  • near-infrared spectroscopy
  • renal
  • splanchnic

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Critical Care and Intensive Care Medicine

Cite this

Change in regional (somatic) near-infrared spectroscopy is not a useful indictor of clinically detectable low cardiac output in children after surgery for congenital heart defects. / Bhalala, Utpal S.; Nishisaki, Akira; McQueen, Derrick; Bird, Geoffrey L.; Morrison, Wynne E.; Nadkarni, Vinay M.; Nathan, Meena; Starr, Joanne P.

In: Pediatric Critical Care Medicine, Vol. 13, No. 5, 09.2012, p. 529-534.

Research output: Contribution to journalArticle

Bhalala, Utpal S. ; Nishisaki, Akira ; McQueen, Derrick ; Bird, Geoffrey L. ; Morrison, Wynne E. ; Nadkarni, Vinay M. ; Nathan, Meena ; Starr, Joanne P. / Change in regional (somatic) near-infrared spectroscopy is not a useful indictor of clinically detectable low cardiac output in children after surgery for congenital heart defects. In: Pediatric Critical Care Medicine. 2012 ; Vol. 13, No. 5. pp. 529-534.
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