Perioperative cerebral oxygen saturation in neonates with hypoplastic left heart syndrome and childhood neurodevelopmental outcome

Hoffman, George M.; Brosig, Cheryl L.; Mussatto, Kathleen A.; Tweddell, James S.; Ghanayem, Nancy S.

doi:10.1016/j.jtcvs.2012.12.060

Cited by 113 publications

(87 citation statements)

References 82 publications

(111 reference statements)

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“…However, NIRS measurements provide only relative data on tissue oxygenation and do not offer information on cerebral perfusion [7]. While some studies were able to show a relation between postoperative NIRS values and neurodevelopmental outcome [23,24], other authors have objections against introducing NIRS as a postoperative standard of care [25].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive assessment of cerebral oxygen metabolism following surgery of congenital heart disease

Neunhoeffer

Sandner

Wiest

et al. 2017

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES: Cerebral protection is a major issue in the treatment of infants with complex congenital heart disease. We tested a new device combining tissue spectrometry and laser Doppler flowmetry for non-invasive determination of cerebral oxygen metabolism following cardiac surgery in infants. METHODS:We prospectively measured regional cerebral oxygen saturation cSO 2 and microperfusion (rcFlow) in 43 infants 12-24 h following corrective (n = 30) or palliative surgery (n = 13) of congenital heart defects. For comparison, cerebral blood flow (CBF) was determined by colour duplex sonography of the extracranial cerebral arteries. Cerebral fractional tissue oxygen extraction, approximated cerebral metabolic rate of oxygen (aCMRO 2 ) and cerebral metabolic rate of oxygen (CMRO 2 ) were calculated. CONCLUSIONS: According to our experience, combined photospectrometry and laser Doppler flowmetry enable non-invasive assessment of cerebral oxygen metabolism. The method promises new insights into perioperative cerebral perfusion following palliation or corrective surgery in infancy.

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Section: Discussionmentioning

confidence: 99%

Non-invasive assessment of cerebral oxygen metabolism following surgery of congenital heart disease

Neunhoeffer

Sandner

Wiest

et al. 2017

Interactive CardioVascular and Thoracic Surgery

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“…8 Diminished perioperative cerebral oxygen saturation is correlated with poor neurodevelopment outcomes in cardiothoracic surgery in neonates. 25,26 In a previous study, we assessed the effects of the PP on the sublingual vasculature during laparoscopic pyloromyotomies. 3 The CO 2 gas PP affected the microcirculatory perfusion by altering the microvascular diameter but left perfused vessel density, an oxygen diffusion-related parameter, unhindered.…”

Section: Discussionmentioning

confidence: 99%

Brain Oxygenation During Laparoscopic Correction of Hypertrophic Pyloric Stenosis

Tytgat

Stolwijk

Keunen

et al. 2015

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Low intraoperative rSO 2 -level may impact psychomotor development (15,30,31) and correlate with postoperative cerebral lesions diagnosed by magnetic resonance imaging (15,17,18,23,(31)(32)(33). On the other hand, particularly in the context of aortic arch surgery using RCP, measuring TAV may avoid the potential dangers of excessive cerebral blood flow resulting in cerebral edema or intracranial hemorrhage (22,34).…”

Section: Review Articlementioning

confidence: 99%

Goal-directed-perfusion in neonatal aortic arch surgery

Cesnjevar¹,

Purbojo²,

Muench³

et al. 2016

Transl. Pediatr.

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Reduction of mortality and morbidity in congenital cardiac surgery has always been and remains a major target for the complete team involved. As operative techniques are more and more standardized and refined, surgical risk and associated complication rates have constantly been reduced to an acceptable level but are both still present. Aortic arch surgery in neonates seems to be of particular interest, because perfusion techniques differ widely among institutions and an ideal form of a so called "total body perfusion (TBP)" is somewhat difficult to achieve. Thus concepts of deep hypothermic circulatory arrest (DHCA), regional cerebral perfusion (RCP/with cardioplegic cardiac arrest or on the perfused beating heart) and TBP exist in parallel and all carry an individual risk for organ damage related to perfusion management, chosen core temperature and time on bypass. Patient safety relies more and more on adequate end organ perfusion on cardiopulmonary bypass, especially sensitive organs like the brain, heart, kidney, liver and the gut, whereby on adequate tissue protection, temperature management and oxygen delivery should be visualized and monitored.

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Perioperative cerebral oxygen saturation in neonates with hypoplastic left heart syndrome and childhood neurodevelopmental outcome

Cited by 113 publications

References 82 publications

Non-invasive assessment of cerebral oxygen metabolism following surgery of congenital heart disease

Non-invasive assessment of cerebral oxygen metabolism following surgery of congenital heart disease

Brain Oxygenation During Laparoscopic Correction of Hypertrophic Pyloric Stenosis

Goal-directed-perfusion in neonatal aortic arch surgery

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