TY  - EJOU
AU  - Li, Dan 
AU  - Zhang, Rongyuan 
AU  - Zhou, Yuzi 
AU  - Jiang, Yazhou 
AU  - Wang, Xu 
AU  - Li, Xia 

TI  - Risk Factors of Decreased Abdominal Tissue Oxygen Saturation in Infants with Congenital Heart Disease after Cardiac Surgery
T2  - Structural and Congenital Heart Disease

PY  - 
VL  - 
IS  - 
SN  - 3071-1738

AB  - <b>Background:</b> Infants undergoing surgery for congenital heart disease (CHD) are at high risk of developing gastrointestinal dysfunction (GID). Although abdominal near-infrared spectroscopy (NIRS) for monitoring tissue oxygen saturation (StO<sub>2</sub>) has shown clinical promise, its prognostic value remains to be fully elucidated. This study aimed to identify the risk factors associated with postoperative declines in abdominal StO<sub>2</sub> and to evaluate its correlation with clinical outcomes. <b>Methods</b>: A total of 439 infants undergoing cardiac surgery with cardiopulmonary bypass between January 2024 and January 2025 were retrospectively enrolled. Continuous postoperative NIRS monitoring was performed during the first 72 h of PICU admission, with the minimum abdominal StO<sub>2</sub> across four predefined time points recorded. Clinical outcomes were compared between the low StO<sub>2</sub> group (&lt;70%, n = 124) and the adequate StO<sub>2</sub> group (≥70%, n = 315). Binary logistic regression analysis was conducted to identify independent risk factors for postoperative StO<sub>2</sub> decline, adjusting for covariates including prematurity, body weight, lactate, mean arterial pressure, and oxygenation. <b>Results:</b> Compared with the StO<sub>2</sub> ≥ 70% group, patients in the StO<sub>2</sub> &lt; 70% group were younger (with more neonates and preterm infants) and had lower body weights, lower oxygen saturation during induction and immediately post-surgery, lower mean arterial pressure, lower PaO<sub>2</sub> and SpO<sub>2</sub>, and higher postoperative arterial lactate (all <i>p</i> &lt; 0.05). Multivariate logistic regression identified lower body weight (OR = 0.46, 95% CI: 0.34–0.62, <i>p</i> &lt; 0.01) and prematurity (OR = 2.96, 95% CI: 1.10–7.98, <i>p</i> = 0.03) as independent risk factors for postoperative abdominal StO<sub>2</sub> decline. Although the overall incidence of early GID was 18.7% with no intergroup difference, patients with reduced abdominal StO<sub>2</sub> experienced significantly prolonged mechanical ventilation, longer PICU and hospital stays, and higher hospital costs (all <i>p</i> &lt; 0.05). <b>Conclusions:</b> Low birth weight and prematurity predispose infants to postoperative abdominal StO<sub>2</sub> decline after CHD surgery; this decline is associated with prolonged recovery times and higher costs, though not significantly correlated with early GID.
KW  - Congenital heart disease; gastrointestinal dysfunction; splanchnic near infrared spectroscopy (NIRS); abdominal tissue oxygen saturation

DO  - 10.32604/schd.2026.081407