AUTHOR=Guyon Peter W. , Karamlou Tara , Ratnayaka Kanishka , El-Said Howaida G. , Moore John W. , Rao Rohit P. 

TITLE=An Elusive Prize: Transcutaneous Near InfraRed Spectroscopy (NIRS) Monitoring of the Liver

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.563483

DOI=10.3389/fped.2020.563483

ISSN=2296-2360

ABSTRACT=<p><bold>Introduction:</bold> We postulate a relationship between a transcutaneous hepatic NIRS measurement and a directly obtained hepatic vein saturation. If true, hepatic NIRS monitoring (in conjunction with the current dual-site cerebral-renal NIRS paradigm) might increase the sensitivity for detecting shock since regional oxygen delivery changes in the splanchnic circulation before the kidney or brain. We explored a reliable technique for hepatic NIRS monitoring as a prelude to rigorously testing this hypothesis. This proof-of-concept study aimed to validate hepatic NIRS monitoring by comparing hepatic NIRS measurements to direct hepatic vein samples obtained during cardiac catheterization.</p><p><bold>Method:</bold> IRB-approved prospective pilot study of hepatic NIRS monitoring involving 10 patients without liver disease who were already undergoing elective cardiac catheterization. We placed a NIRS monitor on the skin overlying liver during catheterization. Direct measurement of hepatic vein oxygen saturation during the case compared with simultaneous hepatic NIRS measurement.</p><p><bold>Results:</bold> There was no correlation between the Hepatic NIRS values and the directly measured hepatic vein saturation (<italic>R</italic> = −0.035; <italic>P</italic> = 0.9238). However, the Hepatic NIRS values correlated with the cardiac output (<italic>R</italic> = 0.808; <italic>P</italic> = 0.0047), the systolic arterial blood pressure (<italic>R</italic> = 0.739; <italic>P</italic> = 0.0146), and the diastolic arterial blood pressure (<italic>R</italic> = 0.7548; <italic>P</italic> = 0.0116).</p><p><bold>Conclusions:</bold> Using the technique described, hepatic NIRS does not correlate well with the hepatic vein saturation. Further optimization of the technique might provide a better measurement. Hepatic NIRS does correlate with cardiac output and thus may still provide a valuable additional piece of hemodynamic information when combined with other non-invasive monitoring.</p>