• J. Cardiothorac. Vasc. Anesth. · Oct 2021

    Observational Study

    Interrelations of Intraoperative Changes in Cerebral Tissue Oxygen Saturation with Brain Volumes and Neurodevelopment Outcome After the Comprehensive Stage II Procedure in Infants With Hypoplastic Left Heart Syndrome: A Retrospective Cohort Study.

    • Matthias Mueller, Thomas Zajonz, Valesco Mann, Christian Koerner, Hakan Akintuerk, Uygar Yoerueker, Kristina Heye, Kristina Wetterling, and Bettina Reich.
    • Paediatric Cardiac Anesthesiology Service, Paediatric Heart Centre, Department of Anaesthesiology Intensive Care Medicine, Pain Therapy, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany. Electronic address: Matthias.f.mueller@chiru.med.uni-giessen.de.
    • J. Cardiothorac. Vasc. Anesth. 2021 Oct 1; 35 (10): 2907-2912.

    ObjectivesThe monitoring of cerebral tissue oxygen saturation by near-infrared spectroscopy (ScerebO2) is used widely in pediatric cardiac anesthesia. However, little information is available on the effects of changes in perioperative ScerebO2 on brain morphology and neurologic outcome. The primary hypothesis tested in this study was that intraoperative ScerebO2 during the comprehensive stage II procedure correlated with brain volumes assessed by magnetic resonance imaging and neurodevelopmental scores.DesignRetrospective observational cohort study.SettingUniversity Hospital, Pediatric Heart Centre.Patients And MeasurementsIn 19 infants, the intraoperative course of ScerebO2 during the comprehensive stage II procedure was examined. Minimal ScerebO2 and integrated ScerebO2 below 45% (AUC) during surgery, as well as cerebral magnetic resonance imaging (MRI) examinations and Bayley III test at the ages of two-to-three years, were analyzed.Main ResultsA positive correlation between minimal ScerebO2 and intracranial volume (p = 0.0243), total brain volume (p = 0.0243), and white matter volume (p = 0.0276) was observed, as was a negative correlation between AUC and intracranial volume (p = 0.0454) and white matter volume (p = 0.0381), respectively. No association was found between ScerebO2 and Bayley-III Score.ConclusionThe correlation between ScerebO2 and brain volumes measured by MRI pointed out a possible importance of neuroprotective strategies aimed at optimizing ScerebO2 during complex congenital heart surgery. That no correlation between ScerebO2 and Bayley III Score was found suggested multifactorial causes for neurologic outcome in children with congenital heart defects.Copyright © 2020 Elsevier Inc. All rights reserved.

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