Skip to main content
Log in

Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children

  • Pediatric Original
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Objective

To compare the cerebral tissue oxygenation index (TOI) measured by near-infrared spectroscopy (NIRS) with venous oxygen saturation in the jugular bulb (SjO2) during elective cardiac catheterization in children.

Design and setting

Prospective observational clinical study in a catheterization laboratory for pediatric cardiology.

Patients

Sixty children with congenital heart defects admitted to the catheterization laboratory.

Measurements and results

TOI measured noninvasively by NIRS was compared to SjO2 measured in the jugular bulb during cardiac catheterization. Patients were divided into two groups regarding body weight: below (n=29) and above 10 kg (n=31). Linear regression analysis and Pearson’s correlation coefficient were calculated. Bland-Altman analysis, sensitivity, and specificity calculation for spatially resolved near-infrared spectroscopy with a cutoff level of 60% were performed. Simultaneously measured values for SjO2 (67.3±9.8%, 40–84.1%) and TOI (65.7±7.2%, 39–80%) showed a significant correlation; the correlation in children weighing under 10 kg was stronger in children weighing over 10 kg. Bland-Altman analysis showed a mean bias of −1.8% with limits of agreement between 11.7% and −15.3% for all children. Sensitivity and specificity of the SRS method were 46% and 91%, respectively, for all children and 53% and 83% respectively in infants weighing under 10 kg.

Conclusions

The results demonstrate that despite a significant correlation, sensitivity of spatially resolved spectroscopy is poor, and it is questionable whether TOI can be used reliably to detect low SjO2.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Jonas RA (1998) Neurological protection during cardiopulmonary bypass/deep hypothermia. Pediatr Cardiol 19:321–330

    Google Scholar 

  2. Nagdyman N, Fleck TP, Ewert P, Abdul-Khaliq H, Redlin M, Lange PE (2003) Cerebral oxygenation measured by near-infrared spectroscopy during circulatory arrest and cardiopulmonary resuscitation. Br J Anaesth 91:438–442

    Google Scholar 

  3. Wypij D, Newburger JW, Rappaport LA, duPlessis AJ, Jonas RA, Wernovsky G, Lin M, Bellinger DC (2003) The effect of duration of deep hypothermic circulatory arrest in infant heart surgery on late neurodevelopment: the Boston Circulatory Arrest Trial. J Thorac Cardiovasc Surg 126:1397–1403

    Google Scholar 

  4. Dittrich H, Buhrer C, Grimmer I, Dittrich S, Abdul-Khaliq H, Lange PE (2003) Neurodevelopment at 1 year of age in infants with congenital heart disease. Heart 89:436–441

    Google Scholar 

  5. Cruz J (1998) The first decade of continuous monitoring of jugular bulb oxyhemoglobinsaturation: management strategies and clinical outcome. Crit Care Med 26:344–351

    Google Scholar 

  6. Gayle MO, Frewen TC, Armstrong RF, Gilbert JJ, Kronick JB, Kissoon N, Lee R, Tiffin N, Brown T (1989) Jugular venous bulb catheterization in infants and children. Crit Care Med 17:385–388

    Google Scholar 

  7. Jobsis FF (1977) Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science 198:1264–1267

    CAS  PubMed  Google Scholar 

  8. Wahr JA, Tremper KK, Samra S, Delpy DT (1996) Near-infrared spectroscopy: theory and applications. J Cardiothorac Vasc Anesth 10:406–418

    CAS  PubMed  Google Scholar 

  9. Adcock LM, Wafelman LS, Hegemier S, Moise AA, Speer ME, Contant CF, Goddard-Finegold J (1999) Neonatal intensive care applications of near-infrared spectroscopy. Clin Perinatol 26:893–903

    Google Scholar 

  10. Schulz G, Weiss M, Bauersfeld U, Teller J, Haensse D, Bucher HU, Baenziger O (2002) Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation. Intensive Care Med 28:184–189

    Article  PubMed  Google Scholar 

  11. Fortune PM, Wagstaff M, Petros AJ (2001) Cerebro-splanchnic oxygenation ratio (CSOR) using near infrared spectroscopy may be able to predict splanchnic ischaemia in neonates. Intensive Care Med 27:1401–1407

    Google Scholar 

  12. Abdul-Khaliq H, Troitzsch D, Schubert S, Wehsack A, Bottcher W, Gutsch E, Hubler M, Hetzer R, Lange PE (2002) Cerebral oxygen monitoring during neonatal cardiopulmonary bypass and deep hypothermic circulatory arrest. Thorac Cardiovasc Surg 50:77–81

    Google Scholar 

  13. Kurth CD, Steven JM, Nicolson SC, Jacobs ML (1997) cerebral oxygenation during cardiopulmonary bypass in children. J Thorac Cardiovasc Surg 113:71–79

    Google Scholar 

  14. Nollert G, Jonas JA, Reichart B (2000) Optimizing cerebral oxygenation during cardiac surgery: a review of experimental and clinical investigations with near infrared spectrophometry. Thorac Cardiovasc Surg 48:247–253

    Google Scholar 

  15. Fallon P, Rboberts I, Kirkham FJ (1993) Cerebral hemodynamics during cardiopulmonary bypass in children using near-infrared spectroscopy. Ann Thorac Surg 56:1473–1477

    CAS  PubMed  Google Scholar 

  16. Thavasothy M, Broadhead M, Elwell C, Peters M, Smith M (2002) A comparison of cerebral oxygenation as measured by the NIRO 300 and the INVOS 5100 Near-Infrared Spectrophotometers. Anaesthesia 57:999–1006

    Article  CAS  PubMed  Google Scholar 

  17. Matcher SJ, Kirkpatrick P, Nahid K, Cope M, Delpy DT (1995) Absolute quantification methods in tissue near infrared spectroscopy. Proc SPIE 2389:486–495

    Google Scholar 

  18. Suzuki S, Takasaki S, Ozaki T, Kobayashi Y (1999) A tissue oxygenation monitor using NIR spatially resolved spectroscopy. Proc SPIE 3579:486–495

    Google Scholar 

  19. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet I:307–310

    Google Scholar 

  20. Brown R, Wright G, Royston D (1993) A comparison of two systems for assessing cerebral venous oxyhaemoglobin saturation during cardiopulmonary bypass in humans. Anaesthesia 48:697–700

    CAS  PubMed  Google Scholar 

  21. Daubeney PE, Pilkington SN, Janke E, Charlton GA, Smith DC, Webber SA (1996) Cerebral oxygenation measured by near-infrared spectroscopy: comparison with jugular bulb oximetry. Ann Thorac Surg 61:930–934

    Article  CAS  PubMed  Google Scholar 

  22. Abdul-Khaliq H, Weipert T, Alexi-Meskhishvili V, Kuppe H, Hetzer R, Lange PE (1998) Perioperative Überwachung der zerebralen Oxygenierung mit Hilfe der Nahinfrarotspektroskopie in der pädiatrischen Herzchirurgie. Z Herz Thorax Gefasschir 12:65–72

    Google Scholar 

  23. Ter Minassian A, Poirier N, Pierrot M, Menei P, Grany JC, Ursino M, Beydon L (1999) Correlation between cerebral oxygen saturation measured by near-infrared spectroscopy and jugular oxygen saturation in patients with severe closed head injury. Anesthesiology 91:985–990

    Google Scholar 

  24. Lewis SB, Myburgh JA, Thornton EL, Reilly PL (1996) Cerebral oxygenation monitoring by near-infrared spectroscopy is not clinically useful in patients with severe closed-head injury: a comparison with jugular venous bulb oximetry. Crit Care Med 24:1334–1338

    Article  CAS  PubMed  Google Scholar 

  25. Ali MS, Harmer M, Vaughan RS, Dunne JA, Latto IP (2001) Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery. Can J Anaesth 48:497–501

    CAS  PubMed  Google Scholar 

  26. Wickramasinghe YA, Palmer KS, Houston R, Spencer SA, Thorniley MS, Oeseburg B, Colier W (1993) Effect of fetal hemoglobin on the determination of neonatal cerebral oxygenation by near-infrared spectroscopy. Pediatr Res 34:15–17

    Google Scholar 

  27. Germon TJ, Young AE, Manara AR, Nelson RJ (1995) Extracerebral absorption of near infrared light influences the detection of increased cerebral oxygenation monitored by near infrared spectroscopy. J Neurol Neurosurg Psychiatry 58:477–479

    CAS  PubMed  Google Scholar 

  28. Fearn SJ, Chant HJ, Picton AJ, Mortimer AJ, McCollum CN (1997) The contribution of extracranial blood oxygenation on near-infrared spectroscopy during carotid endarterectomy. Anaesthesia 52:704–705

    Google Scholar 

  29. Chan MT, Lam JM, Gomersall CD (1997) The contribution of extracranial blood oxygenation on near infrared spectroscopy during carotid endarterectomy. Anaesthesia 52:705–706

    Google Scholar 

  30. Al-Rawi PG, Smielewski P, Kirkpatrick PJ (2001) Evaluation of a near-infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head. Stroke 32:2492–500

    CAS  PubMed  Google Scholar 

  31. Buunk G, van der Hoeven JG, Meinders AE (1998) A comparison of near-infrared spectroscopy and jugular bulb oximetry in comatose patients resuscitated from a cardiac arrest. Anaesthesia 53:13–19

    CAS  Google Scholar 

  32. Germon TJ, Kane NM, Manara AR, Nelson RJ (1994) Near-infrared spectroscopy in adults: effects of extracranial ischaemia and intracranial hypoxia on estimation of cerebral oxygenation. Br J Anaesth 73:503–506

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Anne Gale of the Deutsches Herzzentrum Berlin for editorial assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nicole Nagdyman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nagdyman, N., Fleck, T., Schubert, S. et al. Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children. Intensive Care Med 31, 846–850 (2005). https://doi.org/10.1007/s00134-005-2618-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-005-2618-0

Keywords

Navigation