The Clinical Value of Near Infrared Spectroscopy (NIRS) in Facilitating Earlier Intervention in the Pediatric Cardiac Surgery Patient
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Authors
Wilson, Megan
Issue Date
2018-05-12
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Abstract
Children undergoing cardiac surgery are at risk for adverse outcomes in the postoperative period. Hemodynamic compromise is often in its late stages before it is recognized as metabolic acidosis, mixed venous desaturation, or increased serum lactate levels. In the past ten years, the increased use of near infrared spectroscopy (NIRS) monitoring has provided real time and continuous monitoring of regional tissue perfusion. This has allowed for early recognition of low cardiac output states and formation of a trend over several hours or days. NIRS is a valuable tool in the management of these patients, particularly those at high risk of morbidity and mortality, such as the neonates who undergo stage 1 palliation (Norwood procedure) for hypoplastic left heart syndrome (HLHS). However, the use of NIRS is not yet recognized as standard of care and more research must be conducted to determine whether the values generated by NIRS monitoring can consistently alert clinicians to poor tissue perfusion and low cardiac output states in the post-operative period. The purpose of this project is to determine whether head and flank NIRS values correlate with markers of perfusion such as serum lactate and mixed venous oxygen saturation (Sv02), as well as patient outcomes such as length of ICU stay, need for ECMO, days requiring mechanical ventilation, and in hospital death.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University