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

Summary Background 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 (StO 2 ) 1–4 cm below the skin surface. Aims 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. Materials and Methods Direct liver surface and transcutaneous hepatic tissue hemoglobin oxygen saturation (StO 2 ) were measured during occlusions of the hepatic artery and portal vein. Changes in hepatic delivery of oxygen (Hep DO 2 ) were calculated for each ischemic challenge and compared to changes in direct liver surface (DirHepStO 2 ) and transcutaneous liver StO 2 measurements (CutHepStO 2 ). Results In the 15–20 kg animals during complete occlusion, CutHepStO 2 decreased by 6.0(±4.9)%, whilst DirHepStO 2 decreased by 83.7(±7.2)%. In the 5–7 kg animals during complete occlusion, CutHepStO 2 decreased by 27.4(±8.5)%, whilst DirHepStO 2 decreased by 82.8(±4.6)%. Conclusion Transcutaneous hepatic StO 2 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.

Перевод пока недоступен