Cerebral oxygen saturation during the first 72 h after birth in infants diagnosed prenatally with congenital heart disease

Mebius, Mirthe J; Laan, Michelle E. van der; Verhagen, Elise A.; Roofthooft, Marcus T. R.; Bos, Arend F.; Kooi, Elisabeth M. W.

doi:10.1016/j.earlhumdev.2016.10.001

Cited by 23 publications

(23 citation statements)

References 22 publications

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“…Also, similar to our population of CHD patients, Mebius et al [12]. described infants with a duct-dependent pulmonary circulation (similar to our RL population) with up to 12% lower Csat compared to infants with a duct-dependent systemic circulation (similar to our LL population).…”

Section: Discussionsupporting

confidence: 57%

“…These NIRS values correspond to a previously described cohort of patients with prostaglandin-dependent congenital heart defects [12]. While regional oxygenation levels are expected to be lower in a population with CHD with a compensatory increase in tissue oxygen extraction, we are unaware of a previous direct comparison study of Csat and Rsat levels between infants with CHD and control infants without CHD in the immediate postnatal period.…”

Section: Discussionmentioning

confidence: 99%

“…Csat (measured at the level of the frontal cortex) correlates with cerebral perfusion [7, 9] and lower values have been associated with adverse neurological outcomes and ischemic MRI anomalies [10] in specific neonatal populations, including those with CHD [11]. Studies have been performed on select cardiac subgroups (HLHS and transposition of great arteries), but it remains unclear how end-organ oxygenation differs based on the type of cardiac lesion in single ventricular physiology [12, 13]. To our knowledge, no studies have been published using NIRS to explore differences in Csat and Rsat in RL compared to LL.…”

Section: Introductionmentioning

confidence: 99%

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End-Organ Saturation Differences in Early Neonatal Transition for Left- versus Right-Sided Congenital Heart Disease

et al. 2018

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Background: For neonates with congenital heart disease (CHD), left-sided (LL) and right-sided (RL) single ventricular physiologies (LL, hypoplastic left heart syndrome; RL, tricuspid atresia or pulmonary atresia with intact ventricular septum) may demonstrate distinct changes in tissue saturation in the first 72 h of life. Near-infrared spectroscopy (NIRS) can measure regional cerebral saturation (Csat) and renal saturation (Rsat) to clarify differences between LL and RL over time. Objectives: Our primary objective was to measure changes in Csat and Rsat in the first 72 h of life using NIRS between CHD infants with LL compared to RL. The secondary objective was to correlate NIRS values to an echocardiographic marker of perfusion. Method: Newborns with hypoplastic left heart syndrome, tricuspid atresia, and pulmonary atresia with intact ventricular septum from 2013 to 2016 underwent routine NIRS monitoring. Csat, Rsat, and systemic saturations (SpO₂) in the first 72 h of life were retrospectively analyzed and the echocardiographic descending aorta velocity time integral (VTI) was measured. Mixed effects models compared differences over time between LL and RL. Results: The final cohort included 13 LL, 12 RL, and 4 controls. Csat decreased for RL compared to LL (p = 0.005), while Rsat decreased for both (p = 0.008). Over time, SpO₂ increased for LL but decreased for RL (p = 0.046). Compared to the controls, infants with CHD had lower Csat, lower Rsat, and lower SpO₂. The descending aorta VTI was correlated with Rsat (R² = 0.24, p = 0.02). Conclusion: NIRS Csat measures were better preserved in LL compared to RL. Rsat decreased in both groups through time. The correlation between the descending aorta VTI and Rsat suggests an association between NIRS measures of renal saturation and renal perfusion.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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End-Organ Saturation Differences in Early Neonatal Transition for Left- versus Right-Sided Congenital Heart Disease

et al. 2018

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“…The ratio between oxygenated and total hemoglobin represents the regional tissue oxygen saturation [6]. In infants with CHD, multiple studies have investigated tissue oxygenation at various moments during early life [7–14]. Most studies addressed the intraoperative and postoperative period [7–10], but cerebral rSO 2 was also assessed preoperatively in some studies [11–14].…”

Section: Introductionmentioning

confidence: 99%

“…In infants with CHD, multiple studies have investigated tissue oxygenation at various moments during early life [7–14]. Most studies addressed the intraoperative and postoperative period [7–10], but cerebral rSO 2 was also assessed preoperatively in some studies [11–14]. To our knowledge, however, multisite tissue oxygen saturation as a predictor of clinical deterioration in neonates with CHD has not been described before.…”

Section: Introductionmentioning

confidence: 99%

Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease

et al. 2017

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BackgroundSome infants with congenital heart disease are at risk of in-hospital cardiac arrest. To better foresee cardiac arrest in infants with congenital heart disease, it might be useful to continuously assess end-organ perfusion. Near-infrared spectroscopy is a non-invasive method to continuously assess multisite regional tissue oxygen saturation.Case presentationWe report on two infants with duct-dependent congenital heart disease who demonstrated a gradual change in cerebral and/or renal tissue oxygen saturation before cardiopulmonary resuscitation was required. In both cases, other clinical parameters such as heart rate, arterial oxygen saturation and blood pressure did not indicate that deterioration was imminent.ConclusionsThese two cases demonstrate that near-infrared spectroscopy might contribute to detecting a deteriorating clinical condition and might therefore be helpful in averting cardiopulmonary collapse and need for resuscitation in infants with congenital heart disease.

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D-Transposition of the Great Arteries and ductal dependent pulmonary circulation

Ghimire

2017

Early Human Development

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Cerebral oxygen saturation during the first 72 h after birth in infants diagnosed prenatally with congenital heart disease

Cited by 23 publications

References 22 publications

End-Organ Saturation Differences in Early Neonatal Transition for Left- versus Right-Sided Congenital Heart Disease

End-Organ Saturation Differences in Early Neonatal Transition for Left- versus Right-Sided Congenital Heart Disease

Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease

D-Transposition of the Great Arteries and ductal dependent pulmonary circulation

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