Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion

Hoffman, George M.; Stuth, Eckehard A. E.; Jaquiss, Robert D.B.; Vanderwal, Patrick; Staudt, Susan R.; Troshynski, Todd J.; Ghanayem, Nancy S.; Tweddell, James S.

doi:10.1016/j.jtcvs.2003.08.021

Cited by 190 publications

(145 citation statements)

References 44 publications

(71 reference statements)

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“…In several studies, reduced cerebral oxygenation values were reported to be caused by several reasons, such as cardiac manipulation, dissection of surrounding tissues, pericardial suspension, and cannulation of vena cava and aorta, particularly during the pre-bypass period. [17][18][19] In the present study, cerebral oxygenation data of the pre-and post-bypass periods were similar in all time points in both groups.…”

Section: Discussionsupporting

confidence: 67%

An evaluation of bilateral cerebral oxygen saturation during cyanotic and non-cyanotic cardiac surgery

Demir¹

2016

Turk Gogus Kalp Dama

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Section: Discussionsupporting

confidence: 67%

An evaluation of bilateral cerebral oxygen saturation during cyanotic and non-cyanotic cardiac surgery

Demir¹

2016

Turk Gogus Kalp Dama

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“…8 Non-invasive near-infrared spectroscopy (NIRS) technology that has been used to assess neonatal regional tissue oxygenation was utilized to measure oxygenation in cerebral, renal and mesenteric tissue. 9,10,11 The results of this study will add to our knowledge with regard to the role of the PDA in regional tissue oxygenation.…”

Section: Introductionmentioning

confidence: 75%

Regional tissue oxygenation in preterm born infants in association with echocardiographically significant patent ductus arteriosus

2011

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Objective: To analyze the levels of regional tissue oxygenation in preterm infants in association with echocardiographically significant patent ductus arteriosis (PDA).Study Design: Preterm infants with gestational age less than 32 week were enrolled before the first dose of the pharmacological treatment for the PDA. Non-invasive near-infrared spectroscopy (NIRS) technology was utilized to measure cerebral (rSO 2 -C), renal (rSO 2 -R) and mesenteric (rSO 2-M ) tissue oxygenation for approximately 60 min. Regional fractional oxygen extraction (FOE) was calculated using simultaneously measured arterial saturation (SaO 2 ). We analyzed regional tissue oxygenation and oxygen extraction, hemodynamic parameters, and demographic and clinical information in association with the size of the PDA (moderate vs large).Result: Among the 38 enrolled infants, the majority were diagnosed with a large (63.2%, n ¼ 24) and the rest with a moderate-sized PDA. Infants with large and moderate PDA were comparable in terms of gestational age, study age and weight, mode of delivery and hemodynamic parameters. A significantly higher proportion of infants with a moderate PDA were mechanically ventilated as compared with those with a large PDA. We found no significant differences in the rSO 2 -C and rSO 2 -R, irrespective of the type of respiratory support. However, in infants with a large PDA on continuous nasal positive airway pressure (NCPAP), the rSO 2 -M was lower and mesenteric FOE was higher than that in mechanically ventilated neonates with a large PDA, and in those with moderate PDA irrespective of the type of respiratory support. Conclusion:The PDA size did not affect cerebral and renal tissue oxygenation, but the mesenteric tissue oxygenation was decreased in infants with a large PDA on NCPAP.

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“…This group was the first to prove that the brain was oxygenated during this technique, and also demonstrated both blood pressure and flow to the subdiaphragmatic viscera during this technique via the extensive system of collateral arterial supply in neonates. This flow and oxygenation to the lower body is lower than normal bypass flows (13), but nonetheless demonstrates another potential advantage of ACP over DHCA. As detailed elsewhere in this monograph, cannulation technique is critical, because other techniques of ACP cannulation involving direct cannulation of the right innominate artery, with snaring that excludes the subclavian-vertebral artery, could theoretically result in less perfusion to the brain.…”

Section: Details Of Acp Techniquementioning

confidence: 87%

Principles of Antegrade Cerebral Perfusion During Arch Reconstruction in Newborns/Infants

Fraser

Andropoulos

2008

Seminars in Thoracic and Cardiovascular Surgery: Pediatric Card

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Antegrade cerebral perfusion (ACP) is a cardiopulmonary bypass technique that uses special cannulation procedures to perfuse only the brain during neonatal and infant aortic arch reconstruction. It is used in lieu of deep hypothermic circulatory arrest (DHCA), and thus has the theoretical advantage of protecting the brain from hypoxic ischemic injury. Despite this, recent comparative studies have demonstrated no difference in neurodevelopmental outcomes with ACP vs. DHCA for neonatal arch repair. This article presents animal and human data demonstrating that ACP flows less than 30 ml/kg/min are inadequate for many patients, and may be the explanation for lack of outcome difference vs. DHCA. A technique for ACP, its physiologic basis, and a neuromonitoring strategy are presented, and then the results of an outcome study are reviewed demonstrating that with ACP technique at higher flows of 50-80 ml/kg/min guided by neuromonitoring, periventricular leukomalacia (PVL) is eliminated on postoperative brain MRI after neonatal cardiac surgery.

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Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion

Cited by 190 publications

References 44 publications

An evaluation of bilateral cerebral oxygen saturation during cyanotic and non-cyanotic cardiac surgery

An evaluation of bilateral cerebral oxygen saturation during cyanotic and non-cyanotic cardiac surgery

Regional tissue oxygenation in preterm born infants in association with echocardiographically significant patent ductus arteriosus

Principles of Antegrade Cerebral Perfusion During Arch Reconstruction in Newborns/Infants

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