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

医学 磁共振成像 白质 贝利婴儿发育量表 回顾性队列研究 围手术期 大脑大小 队列 麻醉 神经影像学 心脏病学 氧饱和度 队列研究 左心发育不良综合征 内科学 心脏病 放射科 氧气 精神运动学习 精神科 认知 有机化学 化学
作者
Matthias Mueller,Thomas Zajonz,V. Mann,Christian Koerner,Hakan Akintuerk,Uygar Yoerueker,Kristina Heye,Kristina Wetterling,Bettina Reich
出处
期刊:Journal of Cardiothoracic and Vascular Anesthesia [Elsevier]
卷期号:35 (10): 2907-2912 被引量:1
标识
DOI:10.1053/j.jvca.2020.12.013
摘要

The 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.Retrospective observational cohort study.University Hospital, Pediatric Heart Centre.In 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.A 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.The 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.
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