| Regional differences in tissue oxygenation during cardiopulmonary bypass for correction of congenital heart disease in neonates and small infants: relevance of near-infrared spectroscopy. | |
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MedLine Citation:
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PMID: 18954637 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cardiac surgery with cardiopulmonary bypass for correction of congenital heart disease in neonates and small infants is associated with considerable neurologic sequelae. We assessed the extent to which mixed venous oxygen saturation as a measure for adequacy of perfusion, reflects the oxygenation status of upper and lower body compartments. Moreover, we evaluated potential benefits of near-infrared spectroscopic monitoring of regional tissue oxygenation. METHODS: Twenty patients (body weight < 10 kg) undergoing open cardiac procedures with cardiopulmonary bypass were enrolled. Blood samples were obtained in parallel from inferior and superior caval vein cannulas and mixed venous line and assessed for venous oxygen saturation and lactate levels. Data were compared to simultaneously measured tissue oxygenation indices obtained by near-infrared spectroscopy from brain and lower limb. RESULTS: Venous oxygen saturation was lower and lactate concentration higher in blood from superior relative to inferior venous line. Mixed venous oxygen saturation correlated with venous oxygen saturation from inferior venous line and tissue oxygenation index of lower limb. No correlation was found between mixed venous oxygen saturation and venous oxygen saturation from superior venous line or cerebral tissue oxygenation index. CONCLUSION: In neonates and small infants undergoing cardiac surgery with cardiopulmonary bypass, considerable regional differences exist in venous oxygen saturation. Mixed venous oxygen saturation primarily represents lower-torso oxygen status but poorly reflects and systematically overestimates upper-body oxygenation. Near-infrared spectroscopy yields additional information on regional oxygenation and may be valuable in early and sensitive detection of regional malperfusion in critical organs such as the brain. |
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Authors:
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Mathias Redlin; Andreas Koster; Michael Huebler; Wolfgang Boettcher; Nicole Nagdyman; Roland Hetzer; Hermann Kuppe; Wolfgang M Kuebler |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 136 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-28 Completed Date: 2008-12-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 962-7 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesia, Deutsches Herzzentrum Berlin, Berlin, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Gas Analysis Brain / blood supply Cardiac Surgical Procedures / methods, mortality Cardiopulmonary Bypass / methods* Cohort Studies Female Follow-Up Studies Heart Defects, Congenital / diagnosis, mortality, surgery* Hospital Mortality / trends Humans Infant, Newborn Infant, Small for Gestational Age Lower Extremity / blood supply Male Monitoring, Intraoperative / methods Oximetry Oxygen / blood* Oxygen Consumption / physiology Postoperative Complications / mortality Probability Risk Assessment Sensitivity and Specificity Severity of Illness Index Spectroscopy, Near-Infrared* Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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