Cerebral oxygenation during pediatric congenital cardiac surgery and its association with outcome: a retrospective observational study

Abstract

Purpose Non-invasive cerebral oxygen saturation (ScO 2 ) monitoring is an established tool in the intraoperative phase of pediatric congenital cardiac surgery (CCS). This study investigated the association between ScO 2 and postoperative outcome by investigating both baseline ScO 2 values and intraoperative desaturations from baseline. Methods All CCS procedures performed in the period 2010-2017 in our institution in which ScO 2 was monitored were included in this historical cohort study. Baseline ScO 2 was determined after tracheal intubation, before surgical incision. Subgroups were based on cardiac pathology and degree of intracardiac shunting. Poor outcome was defined based on length of stay (LOS) in the intensive care unit (ICU)/hospital, duration of mechanical ventilation (MV),

Comparison of renal region, cerebral and peripheral oxygenation for predicting postoperative renal impairment after CABG

“…In our study we defined baseline values of oxygenation as the mean of those recorded during the 5-min interval prior to incision. Post-induction baseline values might be a better representation of physiologic conditions during surgery than awake baseline values and might therefore be a more realistic basis on which to determine treatment goals [29].…”

“…In our study we defined baseline values of oxygenation as the mean of those recorded during the 5-min interval prior to incision. Post-induction baseline values might be a better representation of physiologic conditions during surgery than awake baseline values and might therefore be a more realistic basis on which to determine treatment goals [ 29 ]. It could be argued that the most substantial part of the damage to the kidneys will occur intraoperatively rather than during induction, and therefore deviations in oxygenation below a stable post-induction level height of oxygenation may be more relevant.…”

Association between regional oxygen saturation and central venous saturation in pediatric patients undergoing cardiac surgery: A prospective observational study

“…6 The intraoperative use of the cerebral rSO 2 in pediatric cardiac surgery has provided an early warning sign of hemodynamic or metabolic compromise, enabling early interventions to prevent or reduce the severity of potentially life-threatening complications. 7 Although some research groups have reported that the use of a CHD patient's baseline rSO 2 after the induction of anesthesia was helpful in predicting clinical outcomes, 8,9 the clinical utility of rSO 2 continues to be a matter of debate. 6 Actually, these studies 8,9 had several limitations due to the study design and a previous study 10 showed that rSO 2 and ScvO 2 showed a significant correlation but absolute values of ScvO 2 tended to overestimate the correspondent rSO 2 values.…”

“…7 Although some research groups have reported that the use of a CHD patient's baseline rSO 2 after the induction of anesthesia was helpful in predicting clinical outcomes, 8,9 the clinical utility of rSO 2 continues to be a matter of debate. 6 Actually, these studies 8,9 had several limitations due to the study design and a previous study 10 showed that rSO 2 and ScvO 2 showed a significant correlation but absolute values of ScvO 2 tended to overestimate the correspondent rSO 2 values. One of the reasons why the value of rSO 2 monitoring in CHD patients is not established may be that the anatomic and physiological factors affecting cerebral and somatic rSO 2 have not been sufficiently clarified.…”

Microvascular effects of oxygen and carbon dioxide measured by vascular occlusion test in healthy volunteers

“…NIRS monitoring is increasingly used in the perioperative and critical care setting (Biedrzycka and Lango, 2016;Scheeren et al, 2019;Vos et al, 2019a), e.g. for cerebral oxygen saturation monitoring (Lee et al, 2018;Weber and Scoones, 2019;Modestini et al, 2020) and for estimating tissue or organ perfusion by an indirect means (Scheeren, 2016). NIRS can be combined with a vascular occlusion test (VOT) (Vos et al, 2019a), which entails inflating a tourniquet rapidly above systolic blood pressure proximal to the NIRS StO 2 measurement site and subsequently deflating the tourniquet.…”