Near-infrared spectroscopy provides continuous monitoring of compromised lower extremity perfusion during cardiac surgery. J Clin Anesth 2016 Jun;31:38-41
Date
05/18/2016Pubmed ID
27185674DOI
10.1016/j.jclinane.2015.12.003Scopus ID
2-s2.0-84962281247 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
Near-infrared spectroscopy (NIRS) is more frequently used to monitor regional oxygenation/perfusion of the cerebral and somatorenal vascular bed during congenital heart surgery. However, NIRS probes can be placed elsewhere to assess regional perfusion. We report the intraoperative use of NIRS probes on both calves of an infant to continuously monitor changes in the regional oxygenation/perfusion of a lower extremity whose perfusion was compromised after femoral arterial line placement. The NIRS trend of the compromised limb was compared with the contralateral limb throughout congenital heart surgery including the period on cardiopulmonary bypass (CPB). Our case report illustrates that NIRS technology can be used to monitor ongoing lower extremity vascular compromise during congenital heart surgery when it is not practical to directly access and continuously assess the limb. Transient vascular compromise after invasive femoral arterial line or sheath placement for cardiac catheterization in small infants is not infrequent. NIRS technology in such circumstances may help to decide whether watchful waiting is acceptable or immediate interventions are indicated. Continuous NIRS monitoring showed that limb regional oxygenation remained depressed during CPB but dramatically increased in the post-CPB period.
Author List
Prkic I, Stuth EAAuthor
Eckehard A. Stuth MD Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Cardiac Surgical ProceduresCardiopulmonary Bypass
Heart Septal Defects
Humans
Infant
Lower Extremity
Monitoring, Intraoperative
Oxygen Consumption
Spectroscopy, Near-Infrared
