Comparison between cerebral tissue oxygenation index measured by near-infrared spectroscopy and venous jugular bulb saturation in children

Intensive Care Med. 2005 Jun;31(6):846-50. doi: 10.1007/s00134-005-2618-0. Epub 2005 Apr 1.


Objective: To compare the cerebral tissue oxygenation index (TOI) measured by near-infrared spectroscopy (NIRS) with venous oxygen saturation in the jugular bulb (SjO(2)) during elective cardiac catheterization in children.

Design and setting: Prospective observational clinical study in a catheterization laboratory for pediatric cardiology.

Patients: Sixty children with congenital heart defects admitted to the catheterization laboratory.

Measurements and results: TOI measured noninvasively by NIRS was compared to SjO(2) measured in the jugular bulb during cardiac catheterization. Patients were divided into two groups regarding body weight: below (n=29) and above 10 kg (n=31). Linear regression analysis and Pearson's correlation coefficient were calculated. Bland-Altman analysis, sensitivity, and specificity calculation for spatially resolved near-infrared spectroscopy with a cutoff level of 60% were performed. Simultaneously measured values for SjO(2) (67.3+/-9.8%, 40-84.1%) and TOI (65.7+/-7.2%, 39-80%) showed a significant correlation; the correlation in children weighing under 10 kg was stronger in children weighing over 10 kg. Bland-Altman analysis showed a mean bias of -1.8% with limits of agreement between 11.7% and -15.3% for all children. Sensitivity and specificity of the SRS method were 46% and 91%, respectively, for all children and 53% and 83% respectively in infants weighing under 10 kg.

Conclusions: The results demonstrate that despite a significant correlation, sensitivity of spatially resolved spectroscopy is poor, and it is questionable whether TOI can be used reliably to detect low SjO(2).

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Brain / blood supply*
  • Cardiac Catheterization
  • Child
  • Child, Preschool
  • Cyanosis
  • Female
  • Heart Defects, Congenital
  • Humans
  • Infant
  • Jugular Veins / metabolism
  • Linear Models
  • Male
  • Observation
  • Oximetry / methods*
  • Prospective Studies
  • Sensitivity and Specificity
  • Spectroscopy, Near-Infrared*