Abstract
The somatic-cerebral regional oxygen saturation (rSO2) gradient has the potential to reveal a low cardiac output state at an early stage, when systemic vascular resistance increases in order to maintain cerebral perfusion, and results in a drop in somatic rSO2. We hypothesized that during neonatal cardiopulmonary bypass (CPB), the somatic-cerebral rSO2 gradient can also signal poor perfusion, as assessed by an increase in lactate concentration. In a retrospective review of neonatal bypass records, we investigated the association between the somatic-cerebral rSO2 gradient and serial lactate measurements. The somatic-cerebral rSO2 gradient, i.e. the area between the somatic and cerebral rSO2, was calculated for each CPB time interval between 2 lactate measurements, using the trapezoidal method. The association between the somatic-cerebral rSO2 gradient and lactate variation was explored using a mixed model for repeated measurements adjusted for the CPB temperature across intervals. A total of 94 CPB intervals were analysed in 24 neonates, median age 6 days, median weight 3.1 kg. The median lactate variation per interval was +0.2 mmol l-1 (range -1.5 to +2.7), the median somatic-cerebral gradient was 0 (range -1229% min to +2049% ...Continue Reading
References
Aug 1, 1992·Radiology·R O BudeC Lundquist
Jul 8, 2000·The Journal of Thoracic and Cardiovascular Surgery·J R CharpieT J Kulik
Mar 14, 2002·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·C Dean KurthJohn McCann
Apr 24, 2004·Anesthesia and Analgesia·Dean B AndropoulosStephen A Stayer
Oct 27, 2004·Anesthesia and Analgesia·Dean B AndropoulosChandra Ramamoorthy
Apr 2, 2005·Intensive Care Medicine·Nicole NagdymanHashim Abdul-Khaliq
Apr 9, 2005·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·George M HoffmanJames S Tweddell
Jan 10, 2006·The Journal of Thoracic and Cardiovascular Surgery·Catherine L DentC Dean Kurth
Aug 4, 2006·Journal of Cardiothoracic and Vascular Anesthesia·George M Hoffman
Oct 29, 2008·The Journal of Thoracic and Cardiovascular Surgery·Mathias RedlinWolfgang M Kuebler
Dec 17, 2008·Paediatric Anaesthesia·Marco RanucciConcetta Carlucci
May 19, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Sujata B ChakravartiShubhika Srivastava
Jul 8, 2010·Circulation·Barry D KussmanJane W Newburger
Jul 14, 2010·Journal of Pediatric Surgery·Nicole P BernalMarjorie J Arca
Nov 19, 2010·Pediatric Cardiology·Gabe E OwensJohn R Charpie
Dec 21, 2010·Surgical Neurology International·Erin A BoothMichael Wider
Feb 22, 2011·Interactive Cardiovascular and Thoracic Surgery·Angela AmigoniRaffaele Bonato
Jan 4, 2012·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Nancy S GhanayemGeorge M Hoffman
Jan 16, 2013·The Journal of Thoracic and Cardiovascular Surgery·Matthew A HazleNeal B Blatt
Jan 16, 2013·The Journal of Thoracic and Cardiovascular Surgery·George M HoffmanNancy S Ghanayem
Oct 1, 2011·World Journal for Pediatric & Congenital Heart Surgery·Colby ColasaccoRobert Spear
Nov 26, 2013·Paediatric Anaesthesia·John P Scott, George M Hoffman
May 23, 2014·Acta Paediatrica·Anna SchneiderMartin Wald
Jan 30, 2015·Artificial Organs·Tuğrul ÖrmeciHalil Türkoğlu
Jan 30, 2015·Critical Care : the Official Journal of the Critical Care Forum·Bettina RufKarl Reiter
Mar 13, 2015·Pediatric Cardiology·Javier Gil-AntonJavier Pilar
Mar 20, 2015·Artificial Organs·Zaccaria RicciPaola Cogo
Mar 23, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Margaux PontaillerOlivier Raisky