290 - Establishing Baseline Normative Values for Pediatric Near-Infrared Spectroscopy
Thursday, May 14, 2020
1:24 PM – 1:32 PM
Location: Terrace: Terrace Level
Participants should be aware of the following financial/non-financial relationships:
David Ashby: No disclosure data submitted.
Andrea Ray, MB, MA: Nothing to disclose
Background and Objectives: Near-infrared spectroscopy (NIRS) is a device that provides a continuous, non-invasive measure of tissue oxygen saturation that has been increasingly used in the pediatric population in various disease states; particularly shock. To date, there are no published normative values for NIRS measurements for children, limiting its clinical utility and inhibiting future research. The purpose of this study was to establish normative NIRS values for children.
Methods: Cross-sectional observational study of 121 healthy children with age appropriate vitals ages 1 month to 18 years old. Three NIRS adhesive skin probes were placed on the midline forehead (cerebral), below the 12th rib in the posterior paravertebral space (renal) and anterior thigh (thigh) of each patient. Continuous NIRS oxygen saturation measures were collected. Patient characteristics were summarized with descriptive statistics. Using bootstrap sampling, reference intervals (RI) with corresponding reference percentiles were established. Paired t-test compared mean NIRS measurements between anatomic sites. Pearson’s correlation was used to evaluate the relationship between mean NIRS measurements and body mass index (BMI).
Results: 121 pediatric patients were included; 50.4% were male with a mean age of 9.5 years (SD 1.2 years). 44.6% were black and 21.9% Hispanic with a mean BMI of 20.5 kg/m2 (SD 5.6 kg/m2). Continuous oxygen saturation measures were collected for a mean of 23.1 min (SD 4.6 min) from all sites. The mean cerebral NIRS was 73.6% (SD 1.7%; range 19-95%; 95% RI 56.6-86.6%). The mean renal NIRS was 77.9% (SD 2.3%; range 15-95%; 95% RI 54.0-94.6%). The mean thigh NIRS was 78.1% (SD 2.0%; range 28-95%; 95% RI 59.3-94.9%). The mean cerebral NIRS measurement is significantly lower compared to the mean renal and thigh measurements (p<0.0001). The correlation between mean renal NIRS measurements and BMI are significant (r=-0.22, p=0.017) and inversely related. The correlation between mean thigh NIRS measurements and BMI are significant (r=-0.32, p<0.001) and inversely related.
Conclusion: This study establishes normal cerebral, renal and thigh NIRS measures for pediatric patients with corresponding reference intervals which may increase the use of this device in clinical care and research. This is the first important step toward evaluating the utility of NIRS in pediatric clinical care.