@Article{chd.2023.030065,
AUTHOR = {Hwa-Young Jang, Sang-Jun Beon, Sung-Hoon Kim, In-Kyung Song, Won-Jung Shin},
TITLE = {Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in Young Infants},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {18},
YEAR = {2023},
NUMBER = {6},
PAGES = {639--647},
URL = {http://www.techscience.com/schd/v18n6/55232},
ISSN = {3071-1738},
ABSTRACT = { <b>Objectives:</b> 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 (ScO<sub>2</sub>) as an index. Further, we determined the association between the discrepancy in ScO<sub>2</sub> and cerebral perfusion pressure during SCP. <b>Methods:</b> The difference in ScO<sub>2</sub> between the left and right cerebral hemispheres (ΔScO<sub>2 Rt-Lt</sub>) was calculated during clamping of the innominate artery (IA) and during SCP. <b>Results:</b> In 25 infants (aged 2 to 78 days), the left and right ScO<sub>2</sub> 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 ScO<sub>2</sub> decreased (median −1.4% and −1.0%, respectively). During SCP, right ΔScO<sub>2</sub> was higher compared to left ΔScO<sub>2</sub> (median 1.5% <i>vs</i>. 0.6%; <i>p</i> < 0.001). Eight patients had a higher right ΔScO<sub>2</sub> than left ΔScO<sub>2</sub> throughout SCP. They had lower ΔScO<sub>2 Rt-Lt</sub> during IA clamping (median −3.2% <i>vs</i>. 0.0%; <i>p</i> < 0.001) and higher ΔScO<sub>2 Rt-Lt</sub> during SCP than others (median 5.0% <i>vs</i>. −0.8%; <i>p</i> < 0.001). During and after SCP, the correlation coefficient between right ΔScO<sub>2</sub> and change in the mean arterial pressure was higher in patients with a discrepancy than in others (r = 0.731 <i>vs</i>. r = 0.519; <i>p</i> < 0.001). <b>Conclusions:</b> 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.},
DOI = {10.32604/chd.2023.030065}
}