Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-09T08:58:10.965Z Has data issue: false hasContentIssue false

Assessing the brain using near-infrared spectroscopy during postoperative ventricular circulatory support

Published online by Cambridge University Press:  08 September 2005

Carmen Giacomuzzi
Affiliation:
Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, United States of America
Eileen Heller
Affiliation:
Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, United States of America
Brian Mejak
Affiliation:
Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, United States of America
Jamie You
Affiliation:
Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, United States of America
Ross Ungerleider
Affiliation:
Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, United States of America
Michael Silberbach
Affiliation:
Doernbecher Children's Hospital, Oregon Health Sciences University, Portland, Oregon, United States of America

Extract

Due to many innovative techniques and technologies, the overall rate of survival for infants undergoing surgical repair of congenital cardiac malformations is excellent. Despite these excellent outcomes, neonates with hypoplasia of the left heart represent a very unique population, and pose difficult challenges for the entire team involved in care. Despite some centers reporting outstanding outcomes, overall rate of survival rate is reported at only 53 percent,1 and survivors often show neurodevelopmental deficits. Many attempts have been made to identify predictors of neurologic outcomes, with heavy concentration around the pre- and peri-operative periods. Little attention has been paid, however, to assessing how attempts at balancing the systemic and pulmonary circulation affect neurodevelopmental outcomes. In the past, we have reported excellent rates of survival with use of routine postoperative circulatory support to augment cardiac output.2,3 This strategy, nonetheless, is still widely debated. It seems plausible that, by augmenting cardiac output in the immediate postoperative period, cerebral perfusion and oxygenation can be optimized, thereby improving neurologic outcomes. In this review, we describe our experience to date in assessing neurological outcomes, and discuss whether outcomes are associated with cerebral saturation and extraction of oxygen during the period of postoperative circulatory assist.

Type
PART 5: CONTEMPORARY ISSUES IN PROTECTING THE BRAIN DURING CONGENITAL CARDIAC SURGERY
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)