Postoperative Cerebral Oxygen Saturation in Children After Congenital Cardiac Surgery and Long-Term Total Intelligence Quotient: A Prospective Observational Study

Carra, Giorgia; Flechet, Marine; Jacobs, An; Verstraete, Sören; Vlasselaers, Dirk; Desmet, Lars; Cleemput, Hanna Van; Wouters, Pieter; Vanhorebeek, Ilse; Berghe, Greet Van den; Güiza, Fabian; Meyfroidt, Geert

doi:10.1097/ccm.0000000000004852

Cited by 8 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As invasive monitoring is not typically applied after OHCA and TCD gives only snapshot information, NIRS remains the preferred, continuous neuromonitor after cardiac arrest. Lower NIRS values have been associated with worse neurological outcomes [10]. Preliminary data appear to indicate that impaired cerebral autoregulation assessed by NIRS is associated with worse outcomes in OHCA [11].…”

Section: Key Pointsmentioning

confidence: 89%

Individualized cerebral perfusion pressure in acute neurological injury: are we ready for clinical use?

Weiss

Meyfroidt

Aries

2022

Current Opinion in Critical Care

Self Cite

View full text Add to dashboard Cite

Purpose of reviewIndividualizing cerebral perfusion pressure based on cerebrovascular autoregulation assessment is a promising concept for neurological injuries where autoregulation is typically impaired. The purpose of this review is to describe the status quo of autoregulation-guided protocols and discuss steps towards clinical use. Recent findingsRetrospective studies have indicated an association of impaired autoregulation and poor clinical outcome in traumatic brain injury (TBI), hypoxic-ischemic brain injury (HIBI) and aneurysmal subarachnoid hemorrhage (aSAH). The feasibility and safety to target a cerebral perfusion pressure optimal for cerebral autoregulation (CPPopt) after TBI was recently assessed by the COGITATE trial. Similarly, the feasibility to calculate a MAP target (MAPopt) based on near-infrared spectroscopy was demonstrated for HIBI. Failure to meet CPPopt is associated with the occurrence of delayed cerebral ischemia in aSAH but interventional trials in this population are lacking. No level I evidence is available on potential effects of autoregulation-guided protocols on clinical outcomes.

show abstract

Section: Key Pointsmentioning

confidence: 89%

Individualized cerebral perfusion pressure in acute neurological injury: are we ready for clinical use?

Weiss

Meyfroidt

Aries

2022

Current Opinion in Critical Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…Monitoring of cerebral oxygen saturation using near-infrared reflectance spectroscopy (NIRS) [3], a non-invasive optical technique, is an efficient way to evaluate regional blood flow and tissue oxygen transport [4]. The association between pre-operative and intraoperative reduction in NIRS value with post-operative mortality, renal failure, and delirium has been established [5][6][7][8][9][10][11][12][13][14][15][16]. Although most studies have focused on monitoring cerebral oxygen saturation, few studies have explored the role of somatic NIRS monitoring.…”

Section: Introductionmentioning

confidence: 99%

Combined cerebral and somatic near-infrared spectroscopy oximetry monitoring during liver surgery: an observational and non-interventional study

Collin

Hu²,

Denault³

et al. 2022

Korean J Anesthesiol

View full text Add to dashboard Cite

show abstract

“…Near‐infrared spectroscopy (NIRS) can noninvasively measure regional cerebral oxygen saturation (SctO2) and/or somatic tissue oxygen saturation (SstO2) at the microvascular level, thereby enabling the detection of mismatches between oxygen supply and consumption 12–14 . In recent years, a large number of studies have reported associations between NIRS measurements (SctO2 and/or SstO2) and neurological complications 15–20 . However, these results are mainly from supine surgery and may not apply to prone surgery.…”

Section: Introductionmentioning

confidence: 99%

“… 12 , 13 , 14 In recent years, a large number of studies have reported associations between NIRS measurements (SctO2 and/or SstO2) and neurological complications. 15 , 16 , 17 , 18 , 19 , 20 However, these results are mainly from supine surgery and may not apply to prone surgery. In prone surgery, SctO2 is likely to be affected by edema of the monitoring site.…”

Section: Introductionmentioning

confidence: 99%

Which Predictor, SctO2 or SstO2, Is more Sensitive for Postoperative Cognitive Dysfunction in Spine Surgery: A Prospective Observational Study?

Guo

Jia

Wang

et al. 2022

Orthopaedic Surgery

View full text Add to dashboard Cite

Objective Patients undergoing spinal surgery in the prone position may experience venous stasis, often resulting in edema in dependent areas of the body, including the head, and increased postoperative cognitive dysfunction (POCD). Not only does POCD present challenges for post‐operative care and recovery, it can also cause permanent damage to the patient's brain and increase mortality and social costs. We aimed to clarify the incidence of POCD in patients with hypertension after prone spine surgery and to further determine the association between intraoperative somatic tissue oxygen saturation (SstO2)/cerebral tissue oxygen saturation (SctO2) and POCD. Methods Patients with hypertension scheduled for open prone spine surgery from January 2020 to April 2021 were included in this single‐center, prospective, observational study. SctO2 and SstO2 were monitored by near‐infrared spectroscopy continuously throughout the surgery. The primary outcome was POCD assessed using the Mini‐Mental Status Examination (MMSE). The association of SstO2 and SctO2 with POCD was evaluated with unadjusted analyses and multivariable logistic regression. Results One hundred and one of 112 identified patients were included, 28 (27.8%) of whom developed POCD. None of the investigated SctO2 indices were predictive of POCD. However, the patients with POCD had greater decreases in intraoperative absolute SstO2 and relative SstO2 than the patients without POCD (P = 0.037, P = 0.036). Moreover, three SstO2 indices were associated with POCD, including a greater absolute SstO2 decrease (P = 0.021), a greater relative SstO2 decrease (P = 0.032), and a drop below 90% of the baseline SstO2 (P = 0.002), independent of ASA III status, preoperative platelets and postoperative sepsis. In addition, there was no correlation between intraoperative SctO2 and intraoperative SstO2 or between their respective absolute declines. Conclusion Twenty‐eight (27.7%) of 101 patients developed POCD in patients with hypertension undergoing prone spine surgery, and intraoperative SstO2 is associated with POCD, whereas SctO2 shows no association with POCD. This study may initially provide a valuable new approach to the prevention of POCD in this population.

show abstract

Postoperative Cerebral Oxygen Saturation in Children After Congenital Cardiac Surgery and Long-Term Total Intelligence Quotient: A Prospective Observational Study

Cited by 8 publications

References 35 publications

Individualized cerebral perfusion pressure in acute neurological injury: are we ready for clinical use?

Individualized cerebral perfusion pressure in acute neurological injury: are we ready for clinical use?

Combined cerebral and somatic near-infrared spectroscopy oximetry monitoring during liver surgery: an observational and non-interventional study

Which Predictor, SctO2 or SstO2, Is more Sensitive for Postoperative Cognitive Dysfunction in Spine Surgery: A Prospective Observational Study?

Contact Info

Product

Resources

About