Cw. Yoxall et al., MEASUREMENT OF CEREBRAL VENOUS OXYHEMOGLOBIN SATURATION IN CHILDREN BY NEAR-INFRARED SPECTROSCOPY AND PARTIAL JUGULAR VENOUS OCCLUSION, Pediatric research, 38(3), 1995, pp. 319-323
Changes in cerebral venous oxyhemoglobin saturation reflect changes in
the balance between cerebral oxygen delivery and cerebral oxygen cons
umption, Invasive monitoring of cerebral venous saturation (CSvo(2)) h
as provided useful information in the management of critically ill adu
lts at risk of cerebral hypoxia. This study describes the development
and validation of a non-invasive method of measuring CSvo(2) suitable
for use in sick neonates using near-infrared spectroscopy (NIRS) and p
artial jugular venous occlusion. This technique was validated by compa
rison with an invasive measurement of CSvo(2), co-oximetry of jugular
bulb blood obtained during cardiac catheterization. Agreement between
the two methods was assessed using the method of J. M. Bland and D, G.
Altman, Fifteen children were studied, aged 3 mo to 14 y (median 2;y)
. CSvo(2) by co-oximetry ranged from 36 to 80% (median 60%). The mean
difference (Co-Oximeter - NIRS) was 1.5%. Limits of agreement were -12
.8 to 15.9%. Three different methods of analyzing the NIRS signal were
compared, The best agreement was obtained when the changes occurring
during the first 5 s of partial jugular venous occlusion were studied.
Greatest accuracy was seen in those subjects with least movement arti
fact, and we believe this technique will be reliable in sick neonates.