1111 Measurement of Hepatic Tissular Rso2 Using Near Infrared Spectroscopy as a Witness of Hepatic Tumor Regression

Abstract

Background and aims: Near InfraRed Spectroscopy (NIRS) is a tool for evaluation of local blood flow and oxygen consumption (VO2) using measurement of regional oxygen saturation (rSO2). Purpose: To describe the feasibility and accuracy of the measurement of hepatic rSO2 (lirSO2) in an infant with tumoral syndrome in acute leukemia. Methods: A 7 weeks old girl was admitted with asthenia, bleeding, respiratory distress and hepatomegaly. Hemogram showed 117000 leucoblasts/mm3, Hb=7.1g/100 ml, 24000 platelets/ mm3. Blood gaz analysis showed : pH=7.37, HCO3- =18 mmol/l, PaCO2=31 mmHg and lactatemia=888 mg/l. Sonography showed a heterogeneous hepatomegaly. Diagnosis of acute monocytic leukemia (AML-M5) was made. Chemotherapy was started (ELAM 02 protocol). Infant was monitored using cardiac monitoring, continuous measurement of oxygen saturation (SpO2) and invasive blood pressure. CerSO2 and lirSO2 were measured using NIRS. rSO2 values were recorded every 6 seconds, hemoglobin and central venous SO2 (SvO2) in vena cava superior every 6 hours. Results: rSO2 measurement began 10 hours after the first chemotherapy (H0). SpO2 value was 96.4±2.0%, cerSO2 was 75.8±3.9% SvO2 values were stable around 70%, suggesting that there was no variation in systemic oxygen transport (TO2) lirSO2 value at H0 was 24.7±7.6% and raised up to 74.0±2.5% at H12. Conclusions: NIRS provides a non-invasive assessment of lirSO2 in acute hemopathies. The decrease in lirSO2 could be the witness of tissular hypoxia induced by myeloproliferation. Our data show an increase in lirSO2 under chemotherapy. NIRS could be helpful to evaluate the decrease in VO2 and the improvement of TO2 during chemotherapy.