Link: http://www.ncbi.nlm.nih.gov/pubmed/26585879

J Pediatr Surg. 2015 Oct 23. pii: S0022-3468(15)00626-0. doi: 10.1016/j.jpedsurg.2015.10.017. [Epub ahead of print]
A novel multimodal computational system using near-infrared spectroscopy to monitor cerebral oxygenation during assisted ventilation in CDH patients.
Cruz SM1, Akinkuotu AC1, Rusin CG2, Cass DL3, Lee TC1, Welty SE4, Olutoye OO5.
Author information
Abstract
BACKGROUND/PURPOSE:
The aim of this study was to create a computational simulator to serve as an early alert system for cerebral hypoxemia prior to the onset of clinical symptoms.

METHODS:
Neonates with congenital diaphragmatic hernia (Jan 2010-Dec 2014) were recruited to collect continuous measurements of cerebral tissue oxygen saturation (cStO2) using a near-infrared spectroscopy (NIRS) device (FORE-SIGHT?, CASMED). Clinicians were blinded to NIRS data and treated infants based on pre-established clinical protocols. Charts were reviewed retrospectively to identify clinical events of hypoxemia (spontaneous, sustained decrease in preductal SpO2<85% leading to ventilator changes). We developed a computational algorithm that determined baseline values, variability and event data for each patient.

RESULTS:
Twenty-three of 36 patients enrolled met data criteria. The algorithm anticipated an event at least 15minutes prior to the event in 77% of cases, with an average pre-event detection of 47minutes (range 16-122minutes). Post-event StO2 (SpO2<85%) was determined to be 63.7%?11.7. In this computational model, the sensitivity to distinguish low states of cerebral perfusion was 94% with a specificity of 96%.

CONCLUSION:
We have developed a computational algorithm with an early warning system that has the potential of being translated into a real-time clinical interface that may improve management of neonates.

Copyright ? 2015 Elsevier Inc. All rights reserved.

KEYWORDS:
CDH; Cerebral oxygenation; Near infrared spectroscopy