Perioperative Assessment of Cerebral Oxygen Metabolism in Infants With Functionally Univentricular Hearts Undergoing the Bidirectional Cavopulmonary Connection

Objectives: The transition from single-ventricle lesions with surgically placed systemic-to-pulmonary artery shunt to the circulation following a bidirectional cavopulmonary connection results in higher pressure in the superior vena cava when compared with the preceding circulation. The aim of this study was to evaluate the impact of this transition on the perioperative cerebral oxygen metabolism. Design: Prospective observational cohort study. Setting: Pediatric critical care unit of a tertiary referral center. Patients: Sixteen infants after bidirectional cavopulmonary connection. Intervention: Cardiac surgery (bidirectional cavopulmonary connection). Measurements and Main Results: We measured regional cerebral oxygen saturation, amount of hemoglobin, blood flow velocity, and microperfusion immediately before, 12–24 hours, and 36–48 hours following bidirectional cavopulmonary connection. Based on these measurements, we calculated cerebral fractional tissue oxygen extraction and approximated cerebral metabolic rate of oxygen. Mean pressure in the superior vena cava increased significantly (8 vs 17 mm Hg; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

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