Computed tomography scan measurement of abdominal wall thickness for application of near-infrared spectroscopy probes to monitor regional oxygen saturation index of gastrointestinal and renal circulations in children.
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OBJECTIVES: To measure abdominal wall thickness to determine the depth at which the renal vascular bed and mesenteric vascular bed are located, and to determine the appropriate site for placement of near-infrared spectroscopy probes for accurate monitoring regional oxygen saturation index in children. DESIGN: Abdominal computerized tomography scans in children were used to measure the abdominal wall thickness and to ascertain the location of kidneys. SETTING: Tertiary care children's hospital. SUBJECTS: Children 0-18 yrs of age; n = 38. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The main mass of the kidneys is located between vertebral levels T12 and L2 on both sides. The left kidney is located about a half-vertebral length higher than the right kidney. Posterior abdominal wall thickness ranged from 6.6 to 115.8 mm (median, 22.1 mm). Posterolateral abdominal wall thickness ranged from 6.7 to 114.5 mm (median, 19.6 mm). Anterior abdominal wall thickness in the supraumbilical level ranged from 3.5 to 62.9 mm (median, 16.0 mm). All abdominal wall thicknesses correlated better with weight of the subjects than their age. CONCLUSION: Abdominal wall thickness potentially exceeds the sampling depth of currently used near-infrared spectroscopy probes above a certain body size. Application of current near-infrared spectroscopy probes and design of future probes should consider patient size variations in the pediatric population.
