Decreased Tissue Oxygenation in Newborns with Congenital Heart Defects: a Case-control Study

Overview

Journal Croat Med J

Specialty General Medicine

Date 2018 May 10

PMID 29740991

Citations 2

Authors

Petja Fister

Domen Robek

Darja Paro-Panjan

Uros Mazic

Helena Lenasi

Affiliations

Soon will be listed here.

Abstract

Aim: To compare regional tissue oxygenation (rSO2) in the brain, intestine, and kidney between newborns with and without congenital heart defects (CHD).

Methods: This observational case-control study was conducted at the Neonatal Department of Children's Hospital Ljubljana between December 2012 and April 2014. It included 35 newborns with CHD and 30 healthy age- and sex-matched controls. CHD were assessed echocardiographically and divided into acyanotic and cyanotic group. RSO2 in the brain, intestine, and kidney was measured using near-infrared spectroscopy (NIRS). Simultaneously, heart rate (HR), breathing frequency (BF), mean arterial blood pressure (MAP), and arterial oxygen saturation (Sao2) were recorded.

Results: Newborns with CHD had significantly lower rSO2 in the left brain hemisphere (67±11% vs 76±8%, P=0.004), right brain hemisphere (68±11% vs 77±8%, P<0.001), and the kidney (68±13% vs 77±10%, P=0.015). RSO2 in the intestine did not significantly differ between the groups. HR, MAP, and Sao2 also did not differ between the groups, whereas BF was significantly higher in the CHD group (57±12 vs 39±10 breaths/min, P<0.001). Between cyanotic and acyanotic group, we found no significant differences in rSO2 of any tissue.

Conclusions: Monitoring tissue oxygenation by NIRS could enable a timely detection of hemodynamically important CHD.

Citing Articles

Association of preoperative cerebral oxygenation with concurrent neurobehavioral scores in term neonates with congenital heart disease compared to healthy controls.

Tran N, Miner A, Adeleke E, Phan R, Brady K, Brecht M Front Pediatr. 2025; 13:1482257.

PMID: 40026488 PMC: 11868078. DOI: 10.3389/fped.2025.1482257.

Continuous Data-Driven Monitoring in Critical Congenital Heart Disease: Clinical Deterioration Model Development.

Zoodsma R, Bosch R, Alderliesten T, Bollen C, Kappen T, Koomen E JMIR Cardio. 2023; 7:e45190.

PMID: 37191988 PMC: 10230358. DOI: 10.2196/45190.

Blood Glucose and Lactate Levels and Cerebral Oxygenation in Preterm and Term Neonates-A Systematic Qualitative Review of the Literature.

Mattersberger C, Schmolzer G, Urlesberger B, Pichler G Front Pediatr. 2020; 8:361.

PMID: 32903733 PMC: 7438789. DOI: 10.3389/fped.2020.00361.

References

Hsu D, Pearson G . Heart failure in children: part I: history, etiology, and pathophysiology. Circ Heart Fail. 2009; 2(1):63-70. DOI: 10.1161/CIRCHEARTFAILURE.108.820217. View

Madsen P, Skak C, Rasmussen A, Secher N . Interference of cerebral near-infrared oximetry in patients with icterus. Anesth Analg. 2000; 90(2):489-93. DOI: 10.1097/00000539-200002000-00046. View

Lemmers P, Molenschot M, Evens J, Toet M, van Bel F . Is cerebral oxygen supply compromised in preterm infants undergoing surgical closure for patent ductus arteriosus?. Arch Dis Child Fetal Neonatal Ed. 2010; 95(6):F429-34. DOI: 10.1136/adc.2009.180117. View

Amigoni A, Mozzo E, Brugnaro L, Tiberio I, Pittarello D, Stellin G . Four-side near-infrared spectroscopy measured in a paediatric population during surgery for congenital heart disease. Interact Cardiovasc Thorac Surg. 2011; 12(5):707-12. DOI: 10.1510/icvts.2010.253328. View

Chock V, Ramamoorthy C, Van Meurs K . Cerebral oxygenation during different treatment strategies for a patent ductus arteriosus. Neonatology. 2011; 100(3):233-40. DOI: 10.1159/000325149. View

Licht D, Shera D, Clancy R, Wernovsky G, Montenegro L, Nicolson S . Brain maturation is delayed in infants with complex congenital heart defects. J Thorac Cardiovasc Surg. 2009; 137(3):529-36. PMC: 2701902. DOI: 10.1016/j.jtcvs.2008.10.025. View

Owens G, King K, Gurney J, Charpie J . Low renal oximetry correlates with acute kidney injury after infant cardiac surgery. Pediatr Cardiol. 2010; 32(2):183-8. DOI: 10.1007/s00246-010-9839-x. View

Andropoulos D, Hunter J, Nelson D, Stayer S, Stark A, McKenzie E . Brain immaturity is associated with brain injury before and after neonatal cardiac surgery with high-flow bypass and cerebral oxygenation monitoring. J Thorac Cardiovasc Surg. 2009; 139(3):543-56. PMC: 2827639. DOI: 10.1016/j.jtcvs.2009.08.022. View

Jenny C, Biallas M, Trajkovic I, Fauchere J, Bucher H, Wolf M . Reproducibility of cerebral tissue oxygen saturation measurements by near-infrared spectroscopy in newborn infants. J Biomed Opt. 2011; 16(9):097004. DOI: 10.1117/1.3622756. View

10.

Brady K, Lee J, Kibler K, Smielewski P, Czosnyka M, Easley R . Continuous time-domain analysis of cerebrovascular autoregulation using near-infrared spectroscopy. Stroke. 2007; 38(10):2818-25. PMC: 2377358. DOI: 10.1161/STROKEAHA.107.485706. View

11.

van der Laan M, Verhagen E, Bos A, Berger R, Kooi E . Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries. Pediatr Res. 2012; 73(1):62-7. DOI: 10.1038/pr.2012.147. View

12.

Greisen G . Is near-infrared spectroscopy living up to its promises?. Semin Fetal Neonatal Med. 2006; 11(6):498-502. DOI: 10.1016/j.siny.2006.07.010. View

13.

Alderliesten T, Lemmers P, Smarius J, van de Vosse R, Baerts W, van Bel F . Cerebral oxygenation, extraction, and autoregulation in very preterm infants who develop peri-intraventricular hemorrhage. J Pediatr. 2012; 162(4):698-704.e2. DOI: 10.1016/j.jpeds.2012.09.038. View

14.

van Bel F, Lemmers P, Naulaers G . Monitoring neonatal regional cerebral oxygen saturation in clinical practice: value and pitfalls. Neonatology. 2008; 94(4):237-44. DOI: 10.1159/000151642. View

15.

Kurth C, Steven J, Montenegro L, Watzman H, Gaynor J, Spray T . Cerebral oxygen saturation before congenital heart surgery. Ann Thorac Surg. 2001; 72(1):187-92. DOI: 10.1016/s0003-4975(01)02632-7. View

16.

Sorensen L, Greisen G . Precision of measurement of cerebral tissue oxygenation index using near-infrared spectroscopy in preterm neonates. J Biomed Opt. 2006; 11(5):054005. DOI: 10.1117/1.2357730. View

17.

Underwood M, Milstein J, Sherman M . Near-infrared spectroscopy as a screening tool for patent ductus arteriosus in extremely low birth weight infants. Neonatology. 2007; 91(2):134-9. DOI: 10.1159/000097131. View

18.

Mittnacht A . Near infrared spectroscopy in children at high risk of low perfusion. Curr Opin Anaesthesiol. 2010; 23(3):342-7. DOI: 10.1097/ACO.0b013e3283393936. View

19.

Miller S, McQuillen P . Neurology of congenital heart disease: insight from brain imaging. Arch Dis Child Fetal Neonatal Ed. 2007; 92(6):F435-7. PMC: 2675385. DOI: 10.1136/adc.2006.108845. View

20.

Lemmers P, Toet M, van Bel F . Impact of patent ductus arteriosus and subsequent therapy with indomethacin on cerebral oxygenation in preterm infants. Pediatrics. 2008; 121(1):142-7. DOI: 10.1542/peds.2007-0925. View