CEREBRAL OXYGENATION MEASURED BY NEAR-INFRARED SPECTROSCOPY - COMPARISON WITH JUGULAR BULB OXIMETRY

Background. Near-infrared spectroscopy is a potential tool for measuri ng adequacy of cerebral oxygenation during cardiac operations. The cer ebral microcirculation is predominantly venous (by volume) and therefo re regional cerebral oxygenation measured by near-infrared spectroscop y should reflect jugular bulb venous saturations. Methods. We compared simultaneous regional cerebral oxygenation and jugular bulb venous sa turation measurements in 40 children (median age, 4.5 years; range, 2 weeks to 14.5 years) in the cardiac catheter laboratory (n = 29) and d uring cardiac operations (n = 11). Results. For all patients combined the correlation between regional cerebral oxygenation and jugular bulb venous saturation was 0.69 (p < 0.0001) and was similar for the two g roups. For individual children undergoing cardiac operations excellent correlations were obtained (r = 0.78 to 0.96; median, 0.91). However, at low values of jugular bulb venous saturation, regional cerebral ox ygenation tended to run high, whereas the converse was true for high v alues of jugular bulb venous saturation. Conclusions. These findings s uggest that near-infrared spectroscopy may be a useful tool for assess ing intravascular cerebral oxygenation during pediatric cardiac operat ions. Prospective studies of neurologic outcome will be required to es tablish the value of this technique for assessing the adequacy of cere bral protection.