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Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in Young Infants

Hwa-Young Jang1, Sang-Jun Beon2, Sung-Hoon Kim1, In-Kyung Song1, Won-Jung Shin1,*

1 Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
2 Department of Physician Education and Training, Asan Medical Center, Seoul, 05505, Korea

* Corresponding Author: Won-Jung Shin. Email: email

Congenital Heart Disease 2023, 18(6), 639-647. https://doi.org/10.32604/chd.2023.030065

Abstract

Objectives: We investigated whether the selective cerebral perfusion (SCP) technique causes differences in changes in cerebral perfusion between both hemispheres in young infants, using cerebral oxygen saturation (ScO2) as an index. Further, we determined the association between the discrepancy in ScO2 and cerebral perfusion pressure during SCP. Methods: The difference in ScO2 between the left and right cerebral hemispheres (ΔScO2 Rt-Lt) was calculated during clamping of the innominate artery (IA) and during SCP. Results: In 25 infants (aged 2 to 78 days), the left and right ScO2 were well maintained (median 63.2% and 60.9% during IA clamping, respectively; 64.0% and 65.6% during SCP, respectively). During IA clamping, right and left ScO2 decreased (median −1.4% and −1.0%, respectively). During SCP, right ΔScO2 was higher compared to left ΔScO2 (median 1.5% vs. 0.6%; p < 0.001). Eight patients had a higher right ΔScO2 than left ΔScO2 throughout SCP. They had lower ΔScO2 Rt-Lt during IA clamping (median −3.2% vs. 0.0%; p < 0.001) and higher ΔScO2 Rt-Lt during SCP than others (median 5.0% vs. −0.8%; p < 0.001). During and after SCP, the correlation coefficient between right ΔScO2 and change in the mean arterial pressure was higher in patients with a discrepancy than in others (r = 0.731 vs. r = 0.519; p < 0.001). Conclusions: This study suggests that SCP permits adequate bilateral cerebral perfusion. However, the unilateral cerebral perfusion technique may cause a difference in cerebral perfusion between both hemispheres in young infants; this may depend on the perfusion pressure.

Graphical Abstract

Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in Young Infants

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APA Style
Jang, H., Beon, S., Kim, S., Song, I., Shin, W. (2023). Dynamic changes in left and right cerebral oxygen saturation during selective cerebral perfusion in young infants. Congenital Heart Disease, 18(6), 639-647. https://doi.org/10.32604/chd.2023.030065
Vancouver Style
Jang H, Beon S, Kim S, Song I, Shin W. Dynamic changes in left and right cerebral oxygen saturation during selective cerebral perfusion in young infants. Congeni Heart Dis. 2023;18(6):639-647 https://doi.org/10.32604/chd.2023.030065
IEEE Style
H. Jang, S. Beon, S. Kim, I. Song, and W. Shin "Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in Young Infants," Congeni. Heart Dis., vol. 18, no. 6, pp. 639-647. 2023. https://doi.org/10.32604/chd.2023.030065



cc This work is licensed under a Creative Commons Attribution 4.0 International License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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