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Utilizing Near-Infrared Spectroscopy (NIRS) to Identify Pediatric Trauma Patients Needing Lifesaving Interventions (LSIs): A Retrospective Study. Pediatr Emerg Care 2022 Jan 01;38(1):e193-e199

Date

09/11/2020

Pubmed ID

32910035

DOI

10.1097/PEC.0000000000002211

Scopus ID

2-s2.0-85123103771   1 Citation

Abstract

OBJECTIVES: The aim of this study was to investigate the role of near-infrared spectroscopy (NIRS) in identifying pediatric trauma patients who required lifesaving interventions (LSIs).

METHODS: Retrospective chart review of children age 0 to 18 years who activated the trauma team response between January 1, 2015 and August 14, 2017, at a large, urban pediatric emergency department. The lowest somatic NIRS saturation and the need for LSIs (based on published consensus definition) were abstracted from the chart. χ2 and descriptive statistics were used for analysis.

RESULTS: The charts of 84 pediatric trauma patients were reviewed. Overall, 80% were boys with a mean age of 10.4 years (SD, 6.2 years). Injuries included 56% blunt trauma and 36% penetrating trauma with mortality of 10.7% (n = 9). Overall, the median lowest NIRS value was 67% (interquartile range, 51-80%; range, 15%-95%) and 54.8% of the patients had a NIRS value less than 70%. The median somatic NIRS duration recorded was 12 minutes (interquartile range, 6-17 minutes; range, 1-59 minutes). Overall, 50% of patients required a LSI, including 39 who required a lifesaving procedure, 11 required blood products, and 14 required vasopressors. Pediatric trauma patients with NIRS less than 70% had a significantly increased odds of requiring a LSI (odds ratio, 2.67; 95% confidence interval, 1.10-6.47). NIRS less than 70% had a sensitivity and specificity of 67% and 57% respectively.

CONCLUSIONS: Pediatric trauma patients with somatic NIRS less than 70% within 30 minutes of emergency department arrival are associated with the need for LSIs. Continuous NIRS monitoring in the pediatric trauma population should be evaluated prospectively.

Author List

Ashby DW, Gourlay DM, Balakrishnan B, Meyer MT, Drendel AL

Authors

Binod Balakrishnan MBBS Associate Professor in the Pediatrics department at Medical College of Wisconsin
Amy L. Drendel DO Interim Chief, Professor in the Pediatrics department at Medical College of Wisconsin
David M. Gourlay MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Michael T. Meyer MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Child, Preschool
Humans
Infant
Infant, Newborn
Male
Respiration, Artificial
Retrospective Studies
Sensitivity and Specificity
Spectroscopy, Near-Infrared
Wounds, Nonpenetrating