The Correlation of Two Cerebral Saturation Monitors With Jugular Bulb Oxygen Saturation in Children Undergoing Cardiopulmonary Bypass for Congenital Heart Surgery

Naguib, Aymen; Winch, Peter D.; Sebastian, Roby; Gómez, Daniel; Guzmán, L.; Rice, Julie; Tumin, Dmitry; Galantowicz, Mark; Tobias, Joseph D.

doi:10.1177/0885066616663649

Cited by 13 publications

(11 citation statements)

References 14 publications

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“…As NIRS allows for the continuous, non-invasive, portable monitoring of brain oxygen content, it is well-suited for monitoring for brain injury in the adult ECMO population ( 17 ). NIRS oximetry has also been shown to correlate closely with jugular bulb oximetry in pediatric patients undergoing cardiopulmonary bypass, a well-described monitoring technique in a population physiologically similar to VA ECMO ( 18 , 19 ).…”

Section: Discussionmentioning

confidence: 93%

Regional Cerebral Oximetry as an Indicator of Acute Brain Injury in Adults Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation–A Prospective Pilot Study

et al. 2018

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Background: Regional cerebral oxygen saturation (rScO2) measured by near-infrared spectroscopy (NIRS) can be used to monitor brain oxygenation in extracorporeal membrane oxygenation (ECMO). ECMO patients that develop acute brain injuries (ABIs) are observed to have worse outcomes. We evaluated the association between rScO2 and ABI in venoarterial (VA) ECMO patients.Methods: We retrospectively reviewed prospectively-collected NIRS data from patients undergoing VA ECMO from April 2016 to October 2016. Baseline demographics, ECMO and clinical characteristics, cerebral oximetry data, neuroradiographic images, and functional outcomes were reviewed for each patient. rScO2 desaturations were defined as a >25% decline from baseline or an absolute value < 40% and quantified by frequency, duration, and area under the curve per hour of NIRS monitoring (AUC rate, rScO2*min/h). The primary outcome was ABI, defined as abnormalities noted on brain computerized tomography (CT) or magnetic resonance imaging (MRI) obtained during or after ECMO therapy.Results: Eighteen of Twenty patients who underwent NIRS monitoring while on VA ECMO were included in analysis. Eleven patients (61%) experienced rScO2 desaturations. Patients with desaturations were more frequently female (73 vs. 14%, p = 0.05), had acute liver dysfunction (64 vs. 14%, p = 0.05), and higher peak total bilirubin (5.2 mg/dL vs. 1.4 mg/dL, p = 0.02). Six (33%) patients exhibited ABI, and had lower pre-ECMO Glasgow Coma Scale (GCS) scores (5 vs. 10, p = 0.03) and higher peak total bilirubin levels (7.3 vs. 1.4, p = 0.009). All ABI patients experienced rScO2 desaturation while 42% of patients without ABI experienced desaturation (p = 0.04). ABI patients had higher AUC rates than non-ABI patients (right hemisphere: 5.7 vs. 0, p = 0.01, left hemisphere: 119 vs. 0, p = 0.06), more desaturation events (13 vs. 0, p = 0.05), longer desaturation duration (2:33 vs. 0, p = 0.002), and more severe desaturation events with rScO2 < 40 (9 vs. 0, p = 0.05). Patients with ABI had lower GCS scores (post-ECMO initiation) before care withdrawal or discharge than those without ABI (10 vs. 15, p = 0.02).Conclusions: The presence and burden of cerebral desaturations noted on NIRS cerebral oximetry are associated with secondary neurologic injury in adults undergoing VA ECMO.

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Section: Discussionmentioning

confidence: 93%

Regional Cerebral Oximetry as an Indicator of Acute Brain Injury in Adults Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation–A Prospective Pilot Study

et al. 2018

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“…26 Furthermore, different iterations of devices from a variety of manufacturers may perform differently based on internal algorithms. 27,28 It is important to note that rSO 2 has been shown to be useful as a screening tool when somatic and cerebral rSO 2 are used in combination. Specifically, the difference between somatic and cerebral rSO 2 in healthy infants is known to be $10% (ie, renal-somatic rSO 2 is $8-10 greater than cerebral rSO 2 29 ), putatively reflecting the high ratio of oxygen delivery to oxygen demand of the kidneys (given their function as a blood filter) relative to that of the brain.…”

Section: Discussionmentioning

confidence: 99%

Cerebral near-infrared spectroscopy insensitively detects low cerebral venous oxygen saturations after stage 1 palliation

Rescoe

Tang

Perry

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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“…Near-infrared spectroscopy (NIRS) is a useful method to monitor regional cerebral oxygen saturation (rScO 2 ) (9, 10). It has a good correlation with the jugular bulb oxygen saturation (SvjO 2 ) which is considered a gold standard for brain oxygen metabolism (11) and is helpful for timely detection and correction of cerebral ischemia and hypoxia (12).…”

Section: Introductionmentioning

confidence: 99%

Effects of Apolipoprotein E Polymorphism on Cerebral Oxygen Saturation After Traumatic Brain Injury

Xiong

Sun

et al. 2020

Front. Neurol.

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Objective: To investigate the effects of the apolipoprotein E gene (APOE) on the cerebral oxygen saturation of patients after traumatic brain injury (TBI). Methods: Clinical data of 114 patients with TBI and 54 normal people were collected. The APOE genotypes of all subjects were determined by quantitative fluorescent polymerase chain reaction (QF-PCR). The regional cerebral oxygen saturation (rScO 2 ) of TBI patients and normal people were monitored by near-infrared spectroscopy (NIRS). Results: The mean rScO 2 of patients was (55.06 ± 7.60)% in the early stage of TBI, which was significantly lower than that of normal people (67.21 ± 7.80)% ( P < 0.05). Single-factor and multifactor logistic regression analyses showed APOEε4 was an independent risk factor that caused the early decline of rScO2 in TBI patients. Furthermore, in the TBI group, the rScO 2 of APOEε4 carriers (52.23 ± 8.02)% was significantly lower than that of non-ε4 carriers (60.33 ± 7.12)% ( P < 0.05). But in the normal group, no significant differences in rScO 2 were found between APOEε4 carriers and non-carriers. Conclusion: The rScO 2 may be significantly decreased after TBI, and APOEε4 may be a risk factor for decreased rScO 2 in the early stage of TBI.

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The Correlation of Two Cerebral Saturation Monitors With Jugular Bulb Oxygen Saturation in Children Undergoing Cardiopulmonary Bypass for Congenital Heart Surgery

Abstract: INVOS correlated more strongly than FORESIGHT with the jugular bulb rSO at SVC cannulation but may have underestimated oxygen saturation at low rSO values. Data from both NIRS devices were correlated with MAP and ETCO over the case duration.

Cited by 13 publications

References 14 publications

Regional Cerebral Oximetry as an Indicator of Acute Brain Injury in Adults Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation–A Prospective Pilot Study

Regional Cerebral Oximetry as an Indicator of Acute Brain Injury in Adults Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation–A Prospective Pilot Study

Cerebral near-infrared spectroscopy insensitively detects low cerebral venous oxygen saturations after stage 1 palliation

Effects of Apolipoprotein E Polymorphism on Cerebral Oxygen Saturation After Traumatic Brain Injury

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