Document Detail


Near infrared spectroscopy in children at high risk of low perfusion.
MedLine Citation:
PMID:  20421789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Tissue oximetry has been suggested as a noninvasive tool to continuously monitor and detect states of low body perfusion. This review summarizes recent developments and available data on the use of near infrared spectroscopy (NIRS) in children at risk for low perfusion. RECENT FINDINGS: During states of low cardiac output, cerebral blood flow and thus cerebral NIRS may be better preserved than in somatic tissue sites. Consequently, sites other than the frontal cerebral cortex have been investigated for a possible correlation with invasive measures of systemic perfusion and oxygenation (e.g. abdomen, flank, and muscle). The abdominal site seems preferable to the flank site NIRS (kidney region) application. In order to increase the sensitivity, specificity, and positive predictive value of tissue oximetry to detect systemic hypoperfusion, multisite NIRS such as a combination of cerebral and somatic site NIRS has been suggested. NIRS has also been used to assess systemic perfusion in patients undergoing first-stage palliation for hypoplastic left heart syndrome. SUMMARY: Despite shortcomings in the ability of NIRS technology to accurately reflect validated and directly measured parameters of systemic oxygen delivery and blood flow, NIRS can certainly assist in the detection of low-flow states (low cardiac output). Large, randomized, prospective studies with well defined outcome parameters are still missing and warranted in order to clearly define the role of NIRS in children at risk for low perfusion.
Authors:
Alexander J C Mittnacht
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  23     ISSN:  1473-6500     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  342-7     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Mount Sinai Medical Center, New York 10029, USA. alexander.mittnacht@mountsinai.org
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MeSH Terms
Descriptor/Qualifier:
Abdomen / blood supply
Cardiac Output, Low
Cerebral Cortex / blood supply
Cerebrovascular Circulation
Child, Preschool
Humans
Hypoplastic Left Heart Syndrome
Infant
Infant, Newborn
Monitoring, Physiologic / instrumentation,  methods
Oximetry
Regional Blood Flow
Risk
Spectroscopy, Near-Infrared / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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