Journal Highlight: Can transcutaneous near infrared spectroscopy detect severe hepatic ischemia: a juvenile porcine model?

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  • Published: Nov 28, 2016
  • Author: spectroscopyNOW
  • Channels: Infrared Spectroscopy
thumbnail image: Journal Highlight: Can transcutaneous near infrared spectroscopy detect severe hepatic ischemia: a juvenile porcine model?
The suitability of near infrared spectroscopy for monitoring severe hepatic ischemia following pediatric liver transplantation has been studied using juvenile pigs, revealing severe limitations.

Can transcutaneous near infrared spectroscopy detect severe hepatic ischemia: a juvenile porcine model?

Pediatric Anesthesia, 2016, 26, 1188-1196
Justin J. Skowno, Jonathan S. Karpelowsky, Nicola R. Watts and David G. Little

Abstract: Vascular complications following pediatric liver transplantation occur in 8–10% of cases, and no continuous, non-invasive monitoring for this problem exists. Near infrared spectroscopy (NIRS) allows non-invasive, continuous, transcutaneous assessment of hemoglobin oxygenation (StO2) 1–4 cm below the skin surface. We hypothesized that transcutaneous NIRS would be able to detect severe hepatic ischemia, and tested this in an animal model using 15–20 kg and 5–7 kg juvenile pigs. Direct liver surface and transcutaneous hepatic tissue hemoglobin oxygen saturation (StO2) were measured during occlusions of the hepatic artery and portal vein. Changes in hepatic delivery of oxygen (HepDO2) were calculated for each ischemic challenge and compared to changes in direct liver surface (DirHepStO2) and transcutaneous liver StO2 measurements (CutHepStO2). In the 15–20 kg animals during complete occlusion, CutHepStO2 decreased by 6.0(±4.9)%, whilst DirHepStO2 decreased by 83.7(±7.2)%. In the 5–7 kg animals during complete occlusion, CutHepStO2 decreased by 27.4(±8.5)%, whilst DirHepStO2 decreased by 82.8(±4.6)%. Transcutaneous hepatic StO2 monitoring cannot reliably detect severe hepatic ischemia in a juvenile porcine model, although a stronger and potentially useful signal is seen in 5–7 kg pigs. Trials of this technology should be currently restricted to situations where the organ is less than 1 cm from the skin surface, corresponding to infants of <10 kg.

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