| Influence of external cardiac pacing on cerebral oxygenation measured by near-infrared spectroscopy in children after cardiac surgery. | |
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MedLine Citation:
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PMID: 20412455 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The brain of children in the early period after repair of congenital heart defects with cardiopulmonary bypass (CPB) may be more vulnerable to hemodynamic changes because of impaired cerebral autoregulation. During postoperative testing of the external temporary safety pacer, we performed desynchronizing ventricular pacing (VVI) while monitoring cerebral oxygenation using near-infrared spectroscopy (NIRS). METHODS: We prospectively investigated 11 children (6 girls, 5 boys). Mean age was 6.1 months (+/-3.8 months) and mean weight: 5.3 kg (+/-1.5 kg). We performed measurements at four study steps: baseline I, VVI pacing, baseline II and atrial pacing (AOO) to exclude effects of higher heart rate. We continuously measured the effects on hemodynamic and respiratory parameters as well as on cerebral tissue oxygenation index (TOI). Hemoglobin difference (HbD) was calculated as a parameter for cerebral blood flow (CBF). RESULTS: Ventricular pacing leads to a significant decrease in arterial blood pressure and central venous saturation accompanied by an immediate and significant decrease in TOI (63.3% +/- 7.6% to 61.5% +/- 8.4% [P < 0.05]) and HbD (0.51 +/- 1.8 micromol.l(-1) to -2.9 +/- 4.7 micromol.l(-1) [P < 0.05]). CONCLUSION: Cardiac desynchronization after CPB seems to reduce CBF and cerebral oxygenation in children. |
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Authors:
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Thilo Fleck; Stefan Schubert; Matthias Redlin; Brigitte Stiller; Peter Ewert; Felix Berger; Nicole Nagdyman |
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Publication Detail:
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Type: Journal Article Date: 2010-04-12 |
Journal Detail:
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Title: Paediatric anaesthesia Volume: 20 ISSN: 1460-9592 ISO Abbreviation: Paediatr Anaesth Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-10-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9206575 Medline TA: Paediatr Anaesth Country: France |
Other Details:
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Languages: eng Pagination: 553-8 Citation Subset: IM |
Affiliation:
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Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, Berlin, Germany. thilofleck@web.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anesthesia, General Blood Gas Analysis Brain Chemistry / physiology* Cardiac Pacing, Artificial* Cardiac Surgical Procedures* Cerebrovascular Circulation Female Hemodynamics / drug effects Hemoglobins / metabolism Humans Infant Male Oxygen / blood Oxygen Consumption / physiology* Prospective Studies Spectroscopy, Near-Infrared |
| Chemical | |
Reg. No./Substance:
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0/Hemoglobins; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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