Postoperative Cerebral and Somatic Near-Infrared Spectroscopy Saturations and Outcome in Hypoplastic Left Heart Syndrome George M. Hoffman, MD, Nancy.

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Presentation transcript:

Postoperative Cerebral and Somatic Near-Infrared Spectroscopy Saturations and Outcome in Hypoplastic Left Heart Syndrome George M. Hoffman, MD, Nancy S. Ghanayem, MD, John P. Scott, MD, James S. Tweddell, MD, Michael E. Mitchell, MD, Kathleen A. Mussatto, PhD The Annals of Thoracic Surgery Volume 103, Issue 5, Pages 1527-1535 (May 2017) DOI: 10.1016/j.athoracsur.2016.09.100 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Hourly physiologic measures over the first 48 postoperative hours in the comparison group. (MABP = mean arterial blood pressure [black]; rSo2C = cerebral regional oxygen saturation [gray]; rSo2R = somatic regional oxygen saturation [orange]; Sao2 = arterial oxygen saturation [red]; Svo2 = systemic venous oxygen saturation [blue].) The Annals of Thoracic Surgery 2017 103, 1527-1535DOI: (10.1016/j.athoracsur.2016.09.100) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Hourly physiologic measures for survivors (dark blue) versus nonsurvivors (light blue) in the comparison group. (HR = heart rate; MAP = mean arterial pressure; NIRS = near-infrared spectroscopy; DrSo2RC = somatocerebral regional oxygen saturation difference; rSo2C = cerebral regional oxygen saturation; rSo2R = somatic regional oxygen saturation; Sao2 = arterial oxygen saturation; Svo2 = systemic venous oxygen saturation; Svo2mod = linear model of Svo2 predicted from rSo2C and rSo2R.) The Annals of Thoracic Surgery 2017 103, 1527-1535DOI: (10.1016/j.athoracsur.2016.09.100) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Bivariate plot of mean arterial pressure versus somatic regional oxygen saturation (rSo2R) in the comparison group, with cutpoints dividing regions of high cardiac output (CO), high systemic vascular resistance (SVR), low systemic vascular resistance, and low cardiac output. Ellipses show the 95% confidence interval of measures for survivors (green) and nonsurvivors (blue). Nonsurvivors were overrepresented in the low cardiac output region. (BP = blood pressure.) The Annals of Thoracic Surgery 2017 103, 1527-1535DOI: (10.1016/j.athoracsur.2016.09.100) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Predicted survival by bivariate circulatory characterization over the first 6 hours. Disturbances of systemic vascular resistance (SVR) do not affect survival probability, whereas low cardiac output (CO) is associated with lower survival probability. (CI = confidence interval; RR = relative risk.) The Annals of Thoracic Surgery 2017 103, 1527-1535DOI: (10.1016/j.athoracsur.2016.09.100) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions