Background: Cerebral oxygen saturation (rSO2c) decrease from baseline greater than 20 % during infant cardiac surgery\nwas associated with postoperative neurologic changes and neurodevelopmental impairment at 1 year of age. So far,\nthere is no sufficient evidence to support the routinemonitoring of rSO2c during general surgical procedures in children.\nWe aimed to find out the frequency of cerebral desaturation 20 % or more from baseline and to identify possible\npredictors of change in cerebral oxygen saturation during neonatal and infant general surgery.\nMethods: Forty-four infants up to 3 months of age were recruited. Before induction of anesthesia, two pediatric\ncerebral sensors were placed bilaterally to the forehead region and monitoring of regional cerebral saturation of\noxygen was started and continued throughout the surgery. Simultaneously, mean arterial blood pressure (MAP),\npulse oximetry (SpO2), heart rate (HR), endtidal CO2, expired fraction of sevoflurane and rectal temperature were\nrecorded. The main outcome measure was rSO2c value drop-off ââ?°Â¥20 % from baseline. Mann-Whitney U-test,\nchi-squared test, simple and multiple linear regression models were used for statistical analysis.\nResults: Forty-three infants were analyzed. Drop-off ââ?°Â¥20 % in rSO2c from baseline occurred in 8 (18.6 %)\npatients. There were no differences in basal rSO2c, SpO2, HR, endtidal CO2, expired fraction of sevoflurane and\nrectal temperature between patients with and without desaturation 20 % or more from baseline. But the two\ngroups differed with regard to gestation, preoperative mechanical ventilation and the use of vasoactive medications and\nred blood cell transfusions during surgery. Simple linear regression model showed, that gestation, age, preoperative\nmechanical ventilation and mean arterial pressure corresponding to minimal rSO2c value during anesthesia (MAPminrSO2c)\nwere associated with a change in rSO2c values. Multiple regression model including all above mentioned\nvariables, revealed that only MAPminrSO2c was predictive for a change in rSO2c values (Ã?² (95 % confidence interval) -0.28\n(âË?â??0.52ââ?¬â??(âË?â??0.04)) p = 0.02).\nConclusions: Cerebral oxygen desaturation ââ?°Â¥20 % from baseline occurred in almost one fifth of patients. Although\ndifferent perioperative factors can predispose to cerebral oxygenation changes, arterial blood pressure seems to be the\nmost important. Gestation as another possible risk factor needs further investigation
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