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Spectroscopy
Volume 16 (2002), Issue 3-4, Pages 191-197
http://dx.doi.org/10.1155/2002/915063

NIRS Measurement of Peripheral Fractional Oxygen Extraction (FOE) after Cardiopulmonary Bypass

Charles William Yoxall,1 Kusum Menon,2 Andrew John Macnab,3,6 Roy Everett Gagnon,4 and Jacques Gerard LeBlanc5

1Department of Child Health, University of Liverpool, UK
2Department of Paediatrics, University of Ottawa, Ottawa, Canada
3Department of Paediatrics, University of British Columbia, Canada
4British Columbia’s Children’s Hospital, Vancouver, Canada
5Department of Surgery, University of British Columbia, Canada
6Critical Care Physician’s Office, 2L10, Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, Canada

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives: To compare peripheral fractional oxygen extraction (FOE), as measured by near infrared spectroscopy (NIRS), with conventional indicators of tissue perfusion in haemodynamically stable and unstable children after cardiopulmonary bypass. Design: Observational study. Setting: Paediatric Intensive Care Unit of a large teaching hospital. Patients: 17 children immediately after cardiopulmonary bypass. Male : female = 9 : 8, median age 7 months (range, newborn to 16 years). Methods: On admission, children were classified as “stable” or “unstable” based on the haemodynamic support they needed. Peripheral venous oxyhaemoglobin saturation (SvO2) was measured non-invasively using NIRS with venous occlusion. FOE was calculated from SvO2 and arterial saturation measured by pulse oximetry. Repeated measurements of peripheral SvO2 were made for up to 8 hours. In 5 children who had pulmonary artery catheters, simultaneous mixed SvO2 measurements were recorded. Results: Median FOE was 7.9% higher in the unstable group than in the stable group (p = 0.013). Peripheral SvO2 and mixed SvO2 were correlated (R2 = 0.65, p < 0.0001). Conclusions: Peripheral FOE is higher in unstable children. Changes in peripheral SvO2 are related to changes in mixed SvO2. These measurements may provide useful information about haemodynamic status in critically ill children. Further evaluation of the technique is warranted.