The prediction of fluid responsiveness in paediatrics and infants remains problematic. We sought to test the validity of the measurement of StcO₂ as a predictive parameter of fluid responsiveness in infants less than one year old during non-cardiac surgery.

This was a prospective observational study on infants aged less than 1year without any cardiac disease during the intraoperative period of non-cardiac surgery. Cerebral oxygen saturation (StcO₂) was obtained using infrared spectroscopic INVOS^® monitors. Reference values were obtained 10minutes after intubation. Fluid load indications were dependent on the anaesthesiologist caring for the patient. The objective of this study was to determine the accuracy of StcO₂ values before vascular filling (StcO₂B) and the difference in StcO₂ values between the reference value and before vascular filling (ΔStcO₂), in predicting vascular filling response defined as an increase in mean arterial pressure over 15%. Statistical analysis was carried out using ROC curve analysis with determination of grey zones.

Twenty-nine patients were eligible for this study, 23 were included in the study (one intravenous fluid challenge per patient). There were 10 responders and 13 non-responders. The StcO₂B and the ΔStcO₂ were significantly different between responders and non-responders. Analysis of the ROC curve found an area under the curve of 0.75 [95% CI 0.56 to 0.95] for StcO₂B and 0.83 [95% CI 0.66 to 0.99] for ΔStcO₂. The grey-areas were [59–78] and [16–28] for StcO₂B and ΔStcO₂.

NIRS appears to be an interesting additional tool for predicting an increase of blood pressure in response to intraoperative fluid challenge in infants less than one year old.