• Richard J Levy, Whitney B Stern, Kimberly I Minger, Lisa M Montenegro, Chitra Ravishankar, Jonathan J Rome, Susan C Nicolson, and David R Jobes.
• Department of Anesthesiology and Critical Care Medicine and Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
• Pediatr Crit Care Me. 2005 Nov 1; 6 (6): 671-5.

BackgroundMixed venous saturation (S & OV0456;o2) is an important measurement that helps guide the care of critically ill patients. Invasive S & OV0456;o2 assessment in infants and children is often avoided because of the inherent risks. A noninvasive tissue saturation (S to 2) monitor has recently been developed that uses near-infrared spectroscopy to measure oxyhemoglobin saturation in muscle. In adult and animal studies, S to 2 correlated with oxygen delivery and S & OV0456;o2. There has been no evaluation in pediatric patients.ObjectiveTo evaluate tissue saturation as a noninvasive measure of mixed venous saturation in children.DesignA prospective observational study.SettingCatheterization laboratory in a tertiary care children's medical center.PatientsWe studied 98 children (49 without intracardiac mixing and 49 with intracardiac mixing) ResultsNo meaningful correlation was found between S to 2 and superior vena cava saturation or pulmonary artery saturation. Bland-Altman analyses of S to 2 with superior vena cava saturation yielded bias values of -6.67 +/- 37.33% in patients with intracardiac mixing and -0.82 +/- 41.31% in patients without mixing. Bland-Altman analysis of S to 2 with pulmonary artery saturation yielded a bias of 3.61 +/- 41.32% in patients without mixing. Differences between noninvasive and invasive measurements were greatest in smaller children.ConclusionNoninvasive tissue saturation over the deltoid does not correlate with S & OV0456;o2 in children. It is possible that more precise probe spacing, coupled with optimal muscle-mass location, could result in more accurate measures in future investigations.

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