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Agreement between frontal and occipital regional cerebral oxygen saturation in infants during surgery and general anesthesia an observational study

Artikel i vetenskaplig tidskrift
Författare Pether Jildenstål
Margareta Warrén Stomberg
Johan Sandin
Jan Pålsson
Sven-Erik Ricksten
Johan Snygg
Publicerad i Pediatric Anesthesia.
Sidor 1-6
ISSN 1460-9592
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Institutionen för vårdvetenskap och hälsa
Institutionen för kliniska vetenskaper
Sidor 1-6
Språk en
Länkar https://onlinelibrary.wiley.com/doi...
Ämnesord Anesthesiology, anesthetics, cerebral oxygenation, Hemodynamics, inhalation, near‐infrared spectroscopy
Ämneskategorier Pediatrik, Anestesiologi, Anestesi och intensivvård

Sammanfattning

Abstract Background: Advances in perioperative pediatric care have resulted in an increased number of procedures requiring anesthesia. During anesthesia and surgery, the patient is subjected to factors that affect the circulatory homeostasis, which can influence oxygenation of the brain. Near‐infrared spectroscopy (NIRS) is an easy applicable noninvasive method for monitoring of regional tissue oxygenation (rScO₂%). Alternate placements for NIRS have been investigated; however, no alternative cranial placements have been explored. Aim: To evaluate the agreement between frontal and occipital recordings of rScO₂% in infants using INVOSTM during surgery and general anesthesia. Method: A standard frontal monitoring of rScO₂% with NIRS was compared with occipital rScO₂% measurements in fifteen children at an age <1 year, ASA 1‐2, undergoing cleft lip and/or palate surgery during general anesthesia with sevoflurane. An agreement analysis was performed according to Bland and Altman. Results: Mean values of frontal and occipital rScO₂% at baseline were largely similar (70.7 ± 4.77% and 69.40 ± 5.04%, respectively). In the majority of the patients, the frontal and occipital recordings of rScO2 changed in parallel. There was a moderate positive correlation between frontal and occipital rScO₂% INVOS™ readings (rho[ρ]: 0.513, P < .01). The difference between frontal and occipital rScO₂ ranged from −31 to 28 with a mean difference (bias) of −0.15%. The 95% limit of agreement was −18.04%‐17.74%. The error between frontal and occipital rScO₂ recordings was 23%. Conclusion: The agreement between frontal and occipital recordings of brain rScO₂% in infants using INVOSTM during surgery and general anesthesia was acceptable. In surgical procedures where the frontal region of the head is not available for monitoring, occipital recordings of rScO₂% could be an option for monitoring.

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