AUTHOR=Wong Judith Ju-Ming , Chen Ching Kit , Moorakonda Rajesh Babu , Wijeweera Olivia , Tan Tracy Yi Shuen , Nakao Masakazu , Allen John Carson , Loh Tsee Foong , Lee Jan Hau 

TITLE=Changes in Near-Infrared Spectroscopy After Congenital Cyanotic Heart Surgery

JOURNAL=Frontiers in Pediatrics

VOLUME=6

YEAR=2018

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2018.00097

DOI=10.3389/fped.2018.00097

ISSN=2296-2360

ABSTRACT=<sec id="ST1"><title>Background</title><p>Since oxygen saturation from pulse oximetry (SpO<sub>2</sub>) and partial pressure of arterial oxygen (PaO<sub>2</sub>) are observed to improve immediately after surgical correction of cyanotic congenital heart disease (CHD), we postulate that cerebral (CrO<sub>2</sub>) and somatic (SrO<sub>2</sub>) oximetry also improves immediately post-correction. We aim to prospectively examine CrO<sub>2</sub> and SrO<sub>2</sub>, 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.</p></sec><sec id="ST2"><title>Methods</title><p>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<sub>2</sub> and SrO<sub>2</sub> 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.</p></sec><sec id="ST3"><title>Results</title><p>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<sub>2</sub> increased immediately post-CPB compared to pre-CPB [99 (98, 100) vs. 86% (79, 90); <italic>p</italic> &lt; 0.001] and remained in the normal range through to hospital discharge. Post-CPB CrO<sub>2</sub> did not change from pre-CPB [72.8 (58.8, 79.0) vs. 72.1% (63.0, 78.3); <italic>p</italic> = 0.761] and even decreased on hospital discharge [60.5 (53.6, 62.9) vs. 72.1% (63.0, 78.3); <italic>p</italic> = 0.005]. Post-CPB SrO<sub>2</sub> increased compared to pre-CPB [87.3 (77.2, 89.5) vs. 72.7% (65.6, 77.3); <italic>p</italic> = 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); <italic>p</italic> = 0.048].</p></sec><sec id="ST4"><title>Conclusion</title><p>CrO<sub>2</sub> and SrO<sub>2</sub> 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 <uri xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</uri> ID: NCT02417259.)</p></sec>