Near Infrared Spectroscopy To Monitor Cerebral Oxygenation during Antegrade Cerebral Perfusion in Neonates Undergoing Cardiosurgical Repair

Is Bilateral Monitoring of Cerebral Oxygen Saturation Necessary During Neonatal Aortic Arch Reconstruction?

“…It should be emphasized that these relatively high rSo 2 i values were obtained with our high-flow, pH-stat management, ␣-receptor blockade protocol, which yielded RLFP flow rates of 64 mL · kg Ϫ1 · min Ϫ1 . It cannot be assumed that the lower RLFP flow rates of 10 -30 mL · kg Ϫ1 · min Ϫ1 , as reported in other studies, will result in left-sided rSo 2 i values that are more than baseline (6,14).…”

“…Hofer et al (14) studied the effects on rSo 2 i of varying the RLFP flow from 10 to 30 mL · kg Ϫ1 · min Ϫ1 and found lower leftsided rSo 2 i values (mean, 6%-8% lower). These authors used lower RLFP flow rates compared with our average flow rate (63 mL · kg Ϫ1 · min Ϫ1 ).…”

Near-infrared spectroscopy to monitor cerebral oxygen saturation in single-ventricle physiology

“…3 The use of NIRS for brain monitoring has been especially studied in the setting of cardiac operations. In 250 children undergoing operations for congenital heart disease, Austin and coworkers 8,9 found that using NIRS brain monitoring to guide interventions to improve cerebral oxygenation resulted in a decrease in the incidence of neurologic sequelae and shorter hospital stay. Similarly, NIRS has been proposed as a useful tool to monitor brain oxygenation both preoperatively 10 and postoperativly, 11 although the experience in these settings is more limited.…”

“…Few studies on the use of NIRS in children with congenital heart disease have been reported, [8][9][10] and the experience with this technology in cyanotic children with singleventricle physiology (SVP) is limited. 11 In contrast to biventricular physiology, rapid changes in systemic and pulmonary vascular resistance can produce changes in cerebral perfusion in SVP, as well as significant fluctuations in pulmonary blood flow and therefore arterial oxygenation.…”