HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kathleen N. Fenton Kimberly Glogowski Sherrie Fogg Kim F. Duncan Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fenton, K. N. Articles by Duncan, K. F. Search for Related Content PubMed PubMed Citation Articles by Fenton, K. N. Articles by Duncan, K. F. Related Collections Congenital - cyanotic Related Article

Ann Thorac Surg 2007;83:1431-1436
© 2007 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Cerebral Oxygen Saturation Does Not Normalize Until After Stage 2 Single Ventricle Palliation

Department of Surgery, Children’s Hospital, Omaha, Nebraska

Accepted for publication October 3, 2006.

^_* Address correspondence to Dr Fenton, 14805 Maydale Ct, Silver Spring, MD 20905 (Email: kathleennf{at}msn.com).

Background: In an effort to optimize neurologic outcome, cerebral oxygen saturation (ScO ₂) is often measured intraoperatively and postoperatively. We hypothesized that ScO ₂ would be related to stage of palliation in children with single ventricle congenital heart disease.

Methods: Cerebral oxygen saturation was continuously recorded intraoperatively in 34 infants and children undergoing palliative surgery on cardiopulmonary bypass for single ventricle congenital heart defects and in a control group of 12 neonates with ductus-dependent circulation undergoing complete repair. Saturations were correlated with the patient’s stage and outcome.

Results: Baseline ScO ₂ was 61% in single ventricle neonates (group P1, n = 10), 55% in neonates undergoing repair (group R), 42% in infants undergoing stage 2 palliation (group P2, n = 6), and 70% in children undergoing Fontan (group P3, n = 14). Baseline was lowest (41%) in infants undergoing interstage operations (group I, n = 4). After bypass, there was a significant improvement in ScO ₂ to 53% in group P2 infants (p = 0.04); there were no significant changes in the other groups. By the end of the operation, there was a significant decrease in ScO ₂ to 48% in group P1 (p = 0.001), with other groups unchanged from baseline. There were five perioperative deaths. Cerebral oxygen saturation at the conclusion of surgery was lower in children who died (38% versus 61%, p = 0.01).

Conclusions: In children with single ventricle physiology, ScO ₂ decreases after initial palliation, remains low before second-stage palliation, but is normal before and after the Fontan. This has implications for perioperative mortality, neurologic injury, and potentially for interim mortality. Low postoperative ScO ₂ predicts perioperative mortality.

Related Article

Invited commentary

Ralph Delius
Ann. Thorac. Surg. 2007 83: 1436-1437. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				C. D. Kurth, J. C. McCann, J. Wu, L. Miles, and A. W. Loepke Cerebral Oxygen Saturation-Time Threshold for Hypoxic-Ischemic Injury in Piglets Anesth. Analg., April 1, 2009; 108(4): 1268 - 1277. [Abstract] [Full Text] [PDF]

				J. C. Hirsch, J. R. Charpie, R. G. Ohye, and J. G. Gurney Near-infrared spectroscopy: What we know and what we need to know--A systematic review of the congenital heart disease literature J. Thorac. Cardiovasc. Surg., January 1, 2009; 137(1): 154 - 159. [Abstract] [Full Text] [PDF]

				R. Delius Invited commentary Ann. Thorac. Surg., April 1, 2007; 83(4): 1436 - 1437. [Full Text] [PDF]