Correlation between Regional Cerebral Saturation and Invasive Cardiac Index Monitoring after Heart Transplantation Surgery

Awni M. Al-Subu; Christoph P. Hornik; Ira M. Cheifetz; Andrew J. Lodge; George Ofori-Amanfo

doi:10.1055/s-0038-1660788

Journal of Pediatric Intensive Care, Table of Contents

J Pediatr Intensive Care 2018; 07(04): 196-200
DOI: 10.1055/s-0038-1660788

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Correlation between Regional Cerebral Saturation and Invasive Cardiac Index Monitoring after Heart Transplantation Surgery

Awni M. Al-Subu

¹Division of Pediatric Critical Care Medicine, Department of Pediatrics, American Family Children's Hospital, The University of Wisconsin Hospitals and Clinics, Madison, Wisconsin, United States

,

Christoph P. Hornik

²Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina, United States

,

Ira M. Cheifetz

²Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, North Carolina, United States

,

Andrew J. Lodge

³Division of Pediatric Cardiac Surgery, Duke Children's Hospital, Durham, North Carolina, United States

,

George Ofori-Amanfo

⁴Division of Pediatric Critical Care, Department of Pediatrics, Kravis Children's Hospital at Mount Sinai, New York, United States

› Author Affiliations

Abstract

The present study assessed the correlations between cerebral regional saturation detected by near infrared spectroscopy (NIRS) and cardiac index (CI) measured by pulmonary artery catheter. This was a retrospective cohort study conducted in the cardiac intensive care unit in a tertiary care children's hospital. Patients younger than 18 years of age who underwent heart transplantation and had a pulmonary artery catheter on admission to the pediatric cardiac intensive care unit between January, 2010, and August, 2013, were included. There were no interventions. A total of 10 patients were included with median age of 14 years (range, 7–17). Indications for transplantation were dilated cardiomyopathy (n = 9) and restrictive cardiomyopathy (n = 1). Mixed venous oxygen saturation (SvO₂), cerebral regional tissue saturation (rSO₂), and CI were recorded hourly for 8 to 92 hours post-transplantation. Spearman's rank correlation coefficient was used to assess correlations between SvO₂ and cerebral rSO₂ and between CI and cerebral rSO₂. A total of 410 data points were collected. Median, 25th and 75th percentiles of cerebral rSO₂, CI, and SvO₂ were 65% (54–69), 2.9 L/min/m² (2.2–4.0), and 75% (69–79), respectively. The correlation coefficient between cerebral rSO₂ and CI was 0.104 (p = 0.034) and that for cerebral rSO₂ and SvO₂ was 0.11 (p = 0.029). The correlations between cerebral rSO₂ and CI and between cerebral rSO₂ and SvO₂ were weak. Cerebral rSO₂ as detected by NIRS may not be an accurate indicator of CI in critically ill patients.

Keywords

cerebral near infrared spectroscopy - regional oxygen saturation - mixed venous saturation - cardiac output - cardiac index - heart transplant - pediatric

Full Text

References

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