Transcranial measurement of regional cerebral hemoglobin saturation by near-infrared spectroscopy provide non-invasive information on cerebral venous blood saturation in infants and children

Objective: The aim of this study was to investigate the relationship between the non-invasive spectroscopic measurement of rSO2 and the oxymetric determination of the blood saturation in the jugular bulb in infants and children undergoing routine cardiac catheterization. Design: Simultaneous determination of Regional cerebral hemoglobin saturation (rSO2) and Jugular bulb venous saturation (SjO2) in infants and children undergoing routine cardiac catheterization. Patients and participants: 38 infants and children (age 5 days-18.3 years, median 5.6 years) were included in this study. Interventions: The rSO2 was measured continuously using a two chanel cerebral oxymeter (INVOS® 3100A). The sensor was placed in a standardized location on the right temporal head side. After routine oxymetric blood sampling in the superior vena cava the oxymetric catheter was manipulated into the right jugular bulb. After control of the catheter position by imaging the neck area blood sampling for immediate determination of SjO2 was performed. Simultaneous values of the rSO2 were documented. Measurements and results: Over a range of (33-87%) SjO2, a significant linear correlation was found between the spectroscopic measurement of rSO2 and the oxymetric determination of venous blood saturation in the jugular bulb (r=0.94, p=0.0006), superior vena cava (r=0.85, p=0.001). No significant correlation was found between rSO2 and the venous blood saturation in the inferior vena cava (r=0.51, p=0.29) and arterial blood saturation in the descending aorta (r=0.46, p=0.31). Conclusion: Measurement of rSO2 by NIRS may provide continuous non-invasive information on cerebral venous blood saturation and thereby possibly on cerebral oxygen supply and consumption. These may be of clinical value particularly in infants and children undergoing cardiac surgery by means of hypothermic cardiopulmonary bypass.