Pediatric anesthesia & critical care
The effect of intraoperative cerebral oxygen desaturations on postoperative cerebral oxygen metabolism in neonates and infants a pilot study
Authors' conclusion
Cerebral oxygen desaturation during major surgery in neonates and infants is associated with early postoperative increased cerebral oxygen extraction and possibly increased cerebral oxygen metabolism.
Study context
- Population
- Neonates and infants undergoing noncardiac surgery under GA >30 min with invasive arterial BP monitoring; congenital structural heart disease or cerebral disease excludedconsecutive
- Participants
- 37 neonates
- Exposure
- Intraoperative cerebral oxygen desaturation vs no desaturation
- Eventn = 17
- Outcome
- Frequency and severity of intraoperative cerebral oxygen desaturations and their impact on postoperative cerebral oxygen metabolism
- Follow-up
- 1 h postoperatively in the PICU
Main finding
As reported in the abstract
Intraoperative cerebral oxygen desaturation below 20% of baseline
17
46%
Severity of cerebral desaturations, median %min/h (range 0.1-58.7; IQR 0.99-21.29)
4.0
Observational data: associations, not effects.
Further findings
| Outcome | Event | Nonevent | Difference (95% CI) | P value | |
|---|---|---|---|---|---|
| Cerebral fractional tissue oxygen extraction after surgeryMedian | 0.41 (IQR 0.26–0.44) | 0.27 (IQR 0.20–0.31) | −0.11 (−0.17 to −0.05) | P = 0.001 | |
| Range | 0.20-0.55 | 0.11-0.41 | |||
| Approximated cerebral metabolic rate of oxygen after surgery | median 6.15 (IQR 5.12–7.21) arbitrary unit | median 4.14 (IQR 3.82–6.31) arbitrary unit | −1.76 (−3.03 to −0.49) | P = 0.009 | |
| Range | 2.69-12.07 | 1.78-7.86 | |||
| Cerebral regional oxygen saturation after surgeryMedian | 58.99% (IQR 54.26–72.61) | 70.94% (IQR 67.07–76.59) | 10.01 (4.13–15.90) | P = 0.002 | |
| Range | 44.87-79.1 | 57.9-86.13 | |||
| Duration of surgeryMedian, min | 135 (IQR 113.5–167.0) | 46.5 (IQR 30.5–159.3) | −62.94 (−105.17 to −20.71) | P = 0.021 | |
| Range | 11-260 | 11-180 | |||
| −150−100−50050Difference (linear scale) |
Original publication
The effect of intraoperative cerebral oxygen desaturations on postoperative cerebral oxygen metabolism in neonates and infants a pilot study. Paediatr Anaesth. Published 7 November 2023. doi:10.
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