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PEDIATRIC ANESTHESIA

An Evaluation of Bilateral Monitoring of Cerebral Oxygen Saturation During Pediatric Cardiac Surgery

Barry D. Kussman, MBBCh^*||, David Wypij, PhD^#, James A. DiNardo, MD^*||, Jane Newburger, MD, MPH^¶#, Richard A. Jonas, MD^**, Jodi Bartlett, RN^¶, Ellen McGrath, RN^¶, and Peter C. Laussen, MBBS^*||¶

Departments of *Anesthesiology, Perioperative, and Pain Medicine, Clinical Research Program, Cardiology and Cardiovascular Surgery, Children’s Hospital Boston; Departments of ||Anesthesia, ¶Cardiology, #Pediatrics, and **Surgery, Harvard Medical School; and Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts

Address correspondence and reprint requests to Barry D. Kussman, MBBCh, Department of Anesthesiology, Perioperative and Pain Medicine, Children’s Hospital, 300 Longwood Ave., Boston, MA 02115. Address e-mail to barry.kussman{at}childrens.harvard.edu.

Cerebral oximetry is a technique that enables monitoring of regional cerebral oxygenation during cardiac surgery. In this study, we evaluated differences in bi-hemispheric measurement of cerebral oxygen saturation using near-infrared spectroscopy in 62 infants undergoing biventricular repair without aortic arch reconstruction. Left and right regional cerebral oxygen saturation index (rSO₂i) were recorded continuously after the induction of anesthesia, and data were analyzed at 12 time points. Baseline rSO₂i measurements were left 65 ± 13 and right 66 ± 13 (P = 0.17). Mean left and right rSO₂i measurements were similar (2 percentage points/absolute scale units) before, during, and after cardiopulmonary bypass, irrespective of the use of deep hypothermic circulatory arrest. Further longitudinal neurological outcome studies are required to determine whether uni- or bi-hemispheric monitoring is required in this patient population.

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