Tissue oxygenation monitoring during major pediatric surgery using transcutaneous liver near infrared spectroscopy

Background : The aim of the study was to compare liver tissue oxygenation determined by near infrared spectroscopy (NIRS) with central venous oxygen saturation (SvO2) and intestinal perfusion as measured by gastric intramucosal pH (pHi) in pediatric surgical patients. Methods : Twenty children undergoing craniofacial surgery with expected major intraoperative blood loss were studied. NIRS tissue oxygenation index (TOILiver) and pHi values were recorded. Arterial blood gas analysis and SvO2 were assessed from periodically taken blood samples. Data are presented as ranges (median) and were compared using linear regression analysis. Sensitivity and specificity of the intra‐individual changes in TOILiver to predict falling SvO2 or pHi values were calculated. Results : Patients age ranged from 0.79 to 8.27 years (1.92 years). TOILiver ranged from 41.5 to 77.4% (61.5%), gastric pHi from 7.13 to 7.60 (7.37) and SvO2 from 51 to 86% (74%). Among patients only moderate correlation was found between TOILiver and SvO2 (r = 0.594, P