Paediatric anaesthesia & critical care
Age-dependent cerebral oxygenation and brain injury in pediatric cardiac surgery: vulnerability of infants aged ≤6 months
Authors' conclusion
Age affects both rScO2 trajectories and their association with peak NSE. Infants ≤6 months exhibited the lowest rScO2 values and a significant inverse association between the rScO2 nadir and peak NSE
Study context
- Population
- Children undergoing congenital heart surgery with perioperative regional cerebral oxygen saturation (rScO2) monitoring
- Participants
- 104 children
- Exposure
- Age groups ≤6 months vs 6-12 months vs >12 months
- ≤6 monthsn = 47reference
- 6-12 monthsn = 28
- >12 monthsn = 29
- Outcome
- Age-specific perioperative rScO2 trajectories and age modification of the association between rScO2 nadir and peak neurological and myocardial injury biomarkers
Main finding
As reported in the abstract
Β (age × CPB interaction)
4.17 (95% CI [0.47, 7.87]; P = 0.027)
greater rScO2 decrease during CPB in ≤6 months
Β (age × aortic cross-clamp (ACC) interaction)
4.75 (95% CI [1.05, 8.45]; P = 0.012)
greater rScO2 decrease during ACC in ≤6 months
Observational data: associations, not effects.
Further findings
| Outcome | β (95% CI) | P value |
|---|---|---|
| Age interaction for rScO2 nadir–peak NSE association6-12 months vs ≤6 months | 0.41 ([0.05, 0.77]) | P = 0.027 |
| Age interaction for rScO2 nadir–peak NSE association>12 months vs ≤6 months | 0.43 ([0.01, 0.84]) | P = 0.044 |
- rScO2 nadir vs peak NSE, age-stratified (≤6 months subgroup)
- −0.27 · β · 95% CI [−0.48, −0.07]
rScO2 nadir vs peak NSE, age-stratified (≤6 months subgroup)
- Significant inverse association only in the ≤6-month group
rScO2 nadir vs GFAP, S100β, CK-MB, cTnI, NT-proBNP
- No significant associations across age groups
Original publication
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