Beth Ann Johnson, MD, George M. Hoffman, MD, James S

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Presentation transcript:

Near-Infrared Spectroscopy in Neonates Before Palliation of Hypoplastic Left Heart Syndrome Beth Ann Johnson, MD, George M. Hoffman, MD, James S. Tweddell, MD, Joseph R. Cava, MD, PhD, Mir Basir, MD, Michael E. Mitchell, MD, Matthew C. Scanlon, MD, Kathleen A. Mussatto, BSN, PhDc, Nancy S. Ghanayem, MD The Annals of Thoracic Surgery Volume 87, Issue 2, Pages 571-579 (February 2009) DOI: 10.1016/j.athoracsur.2008.10.043 Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Respiratory variables in patients with near-infrared spectroscopy (NIRS) monitoring (dashed line) and without NIRS monitoring (solid line). The NIRS-monitored patients generally had higher SaO2 and PaO2, and lower PaCO2, owing to lower use of mechanical ventilation and less restrictive inspired gas management. (FiO2 = fraction of inspired oxygen.) The Annals of Thoracic Surgery 2009 87, 571-579DOI: (10.1016/j.athoracsur.2008.10.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Standard hemodynamic measurements in patients managed with (dashed line) and without (solid line) near-infrared spectroscopy (NIRS). There were no significant differences except for a reduction in creatinine in NIRS-monitored patients. (BP = blood pressure; ns = not significant.) The Annals of Thoracic Surgery 2009 87, 571-579DOI: (10.1016/j.athoracsur.2008.10.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Hemodynamics in near-infrared spectroscopy (NIRS)-monitored patients, with (dashed line) and without (solid line) mechanical ventilation. Patients who were mechanically ventilated had lower diastolic and mean blood pressures (BP) despite lower SaO2. (ns = not significant.) The Annals of Thoracic Surgery 2009 87, 571-579DOI: (10.1016/j.athoracsur.2008.10.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Cerebral and somatic near-infrared spectroscopy (NIRS) measurements and regional oxygen extraction ratios (OER) in NIRS-monitored patients. Mechanical ventilation resulted in differential effects on regional blood flow: cerebral oxygenation and flow was increased, and somatic oxygenation and flow was decreased, in patients managed with mechanical ventilation. (rSO2 = oxyhemoglobin saturation.) The Annals of Thoracic Surgery 2009 87, 571-579DOI: (10.1016/j.athoracsur.2008.10.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Distribution of patients at incremental levels of ventilation charges. More patients in the near-infrared spectroscopy (NIRS) group had zero charges for ventilation as compared with the control group. The Annals of Thoracic Surgery 2009 87, 571-579DOI: (10.1016/j.athoracsur.2008.10.043) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions