Effect of volume resuscitation on regional perfusion in dehydrated pediatric patients as measured by two-site near-infrared spectroscopy. Pediatr Emerg Care 2009 Mar;25(3):150-3
Date
03/06/2009Pubmed ID
19262423DOI
10.1097/PEC.0b013e31819a7f60Scopus ID
2-s2.0-66249100245 (requires institutional sign-in at Scopus site) 52 CitationsAbstract
OBJECTIVE: The aim of this study was to measure the change of cerebral and somatic regional oxygen saturation (rSO2) using near-infrared spectroscopic (NIRS) monitoring during volume resuscitation of dehydrated children.
METHODS: This prospective, observational study enrolled 17 moderately dehydrated children presenting to the emergency department in a tertiary care pediatric hospital. Pulse oximetry and 2-site rSO2 using forehead and flank NIRS probes were monitored continuously during intravenous rehydration.
RESULTS: Prehydration and posthydration data were summarized as mean (SD) and analyzed by paired 2-sided Student t test. Significance was defined as a P < 0.05. Pulse oximetry and cerebral rSO2 remained unchanged throughout rehydration. The somatic rSO2 increased from 79% (13) to 87% (9) (P < 0.01) with rehydration, and the somatic-cerebral rSO2 difference increased from 5% (7) to 13% (6) (P < 0.001). The high-volume rehydration group (33-40 mL/kg) showed a greater increase in somatic rSO2 with rehydration when compared with the low-volume rehydration group (20 mL/kg). The measured increase in somatic rSO2 was greatest in children weighing less than 15 kg.
CONCLUSIONS: In children with acute dehydration, cerebral rSO2 is preserved in moderate dehydration. Somatic tissue beds show an increase in rSO2 by NIRS oximetry with rehydration. Two-site NIRS monitoring is a continuous, noninvasive quantitative method for early detection of regional hypoperfusion in dehydrated children.
Author List
Hanson SJ, Berens RJ, Havens PL, Kim MK, Hoffman GMAuthors
Richard J. Berens MD Professor in the Anesthesiology department at Medical College of WisconsinGeorge M. Hoffman MD Chief, Professor in the Anesthesiology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentBrain
Child
Child, Preschool
Dehydration
Female
Fluid Therapy
Follow-Up Studies
Humans
Infant
Male
Oximetry
Oxygen
Oxygen Consumption
Perfusion
Prospective Studies
Reproducibility of Results
Resuscitation
Spectroscopy, Near-Infrared
Treatment Outcome
