AI Article Synopsis
- This study investigated the changes in cerebral (CrO) and somatic (SrO) oximetry in children undergoing surgery for cyanotic congenital heart disease (CHD), comparing measurements before, during, and after surgery.
- Results showed that while oxygen saturation (SpO) improved immediately after surgery, CrO did not change and actually decreased by discharge, while SrO initially increased but later declined during the hospital stay.
- The findings suggest that CrO and SrO may not improve post-surgery for cyanotic CHD, indicating the need for further exploration on their recovery patterns.
Article Abstract
Background: Since oxygen saturation from pulse oximetry (SpO) and partial pressure of arterial oxygen (PaO) are observed to improve immediately after surgical correction of cyanotic congenital heart disease (CHD), we postulate that cerebral (CrO) and somatic (SrO) oximetry also improves immediately post-correction. We aim to prospectively examine CrO and SrO, before, during, and after surgical correction as well as on hospital discharge in children with cyanotic CHD to determine if and when these variables increase.
Methods: This is a prospective observational trial. Eligibility criteria included children below 18 years of age with cyanotic CHD who required any cardiac surgical procedure. CrO and SrO measurements were summarized at six time-points for comparison: (1) pre-cardiopulmonary bypass (CPB); (2) during CPB; (3) post-CPB; (4) Day 1 in the pediatric intensive care unit (PICU); (5) Day 2 PICU; and (6) discharge. Categorical and continuous variables are presented as counts (percentages) and median (interquartile range), respectively.
Results: Twenty-one patients were analyzed. 15 (71.4%) and 6 (28.6%) patients underwent corrective and palliative surgeries, respectively. In the corrective surgery group, SpO increased immediately post-CPB compared to pre-CPB [99 (98, 100) vs. 86% (79, 90); < 0.001] and remained in the normal range through to hospital discharge. Post-CPB CrO did not change from pre-CPB [72.8 (58.8, 79.0) vs. 72.1% (63.0, 78.3); = 0.761] and even decreased on hospital discharge [60.5 (53.6, 62.9) vs. 72.1% (63.0, 78.3); = 0.005]. Post-CPB SrO increased compared to pre-CPB [87.3 (77.2, 89.5) vs. 72.7% (65.6, 77.3); = 0.001] but progressively decreased during PICU stay to a value lower than baseline at hospital discharge [66.9 (57.3, 76.9) vs. 72.7% (65.6, 77.3); = 0.048].
Conclusion: CrO and SrO did not increase after corrective surgery of cyanotic CHD even up to hospital discharge. Future larger studies are required to validate these findings. (This study is registered with ClinicalTrials.gov ID: NCT02417259.).
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5908891 | PMC |
| http://dx.doi.org/10.3389/fped.2018.00097 | DOI Listing |
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