The Relationships of Cerebral and Somatic Oxygen Saturation with Physiological Parameters in Pediatric Cardiac Surgery w
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ORIGINAL ARTICLE
The Relationships of Cerebral and Somatic Oxygen Saturation with Physiological Parameters in Pediatric Cardiac Surgery with Cardiopulmonary Bypass: Analysis Using the Random‑Effects Model Masataka Yamamoto1,2 · Toshihiro Mori1 · Takayuki Toki1 · Yusuke Itosu1 · Yasunori Kubo1 · Isao Yokota3 · Yuji Morimoto1,2 Received: 11 June 2020 / Accepted: 30 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Recently, tissue oxygenation in pediatric heart surgery is measured by using near-infrared spectroscopy. Monitoring of cerebral oxygen saturation (ScO2) is most common but that of somatic tissue oxygen saturation (SrO2) is also gradually becoming widespread. However, the value of their monitoring is not well established. One of the reasons for this may be that the physiological factors affecting S cO2 and SrO2 have not been sufficiently clarified. Accordingly, we prospectively observed the changes in S cO2 and S rO2 simultaneously throughout cardiac surgery with cardiopulmonary bypass (CPB) in children weighing under 10 kg and evaluated their relationships with physiological parameters by using the random-effects model. ScO2 and SrO2 were measured with an INVOS 5100C (Somanetics, Troy, MI, USA). The randomeffects analysis was applied for S cO2 and SrO2, as dependent variables, and seven physiological parameters (mean blood pressure, central venous pressure, rectal temperature, SaO2, hematocrit PaCO2, and pH) were entered as independent covariates. The analysis was performed during the pre-CPB, CPB, and post-CPB periods. Next, the same analysis was performed by dividing the patients into univentricular and biventricular physiological types. Forty-one children were evaluated. Through the whole surgical period, S cO2 correlated strongly with mean blood pressure regardless of the physiological type. On the other hand, the contribution of mean blood pressure to SrO2 was weak and various other parameters were related to S rO2 changes. Thus, the physiological parameters affecting S cO2 and S rO2 were rather different. Accordingly, the significance of monitoring of cerebral and somatic tissue oxygen saturation in pediatric cardiac surgery should be further evaluated. Keywords Cerebral oxygen saturation · Somatic oxygen saturation · Pediatric cardiac surgery · Cardiopulmonary bypass · Random-effects model · Autoregulation
Introduction Electronic Supplementary Material The online version of this article (https://doi.org/10.1007/s00246-020-02492-y) contains supplementary material, which is available to authorized users. * Yuji Morimoto [email protected] 1
Department of Anesthesiology, Hokkaido University Hospital, N14 W5, Sapporo 0608648, Japan
2
Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Sapporo 0608638, Japan
3
Department of Biostatistics, Hokkaido University Graduate School of Medicine, N15 W7, Sapporo 0608638, Japan
Recently, tissue oxygenation in p
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