Effect of Hemodilution on Fluctuation of Cerebral Oxygen Saturation during Cardiopulmonary Bypass in Children with Cyanotic Congenital Heart Disease

作     者：Misook Seo In-Kyung Song Hye-Mee Kwon Byungdoo Andrew Lee Won-Jung Shin 

作者机构：Department of AnesthesiologyDamsoyu HospitalSeoulKorea Department Anesthesiology and Pain MedicineLaboratory for Cardiovascular DynamicsAsan Medical CenterUniversity of Ulsan College of MedicineSeoul05505Korea 

出 版 物：《Congenital Heart Disease》 (先天性心脏病（英文）)

年 卷 期：2021年第16卷第2期

页      面：123-136页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Cardiopulmonary bypass cerebral oxygen saturation children congenital heart disease hemodilution 

摘      要：Background:In patients with cyanotic congenital heart disease(CHD),cerebral oxygenation may be maintained by elevations in hematocrit(Hct).Hemodilution accompanying cardiopulmonary bypass(CPB),however,can disrupt cerebral oxygen balance,leading to fluctuations in cerebral oxygen saturation(ScO_(2)).The present study investigated the effects of Hct changes on the fluctuation of ScO_(2)during CPB in cyanotic CHD using performance measurement(PM).Methods:Children with CHD(51 acyanotic and 46 cyanotic)who had undergone cardiac surgery using CPB were *** performance error(MDPE),median absolute performance error(MDAPE),and wobble parameters of ScO_(2)were calculated before(reference value),during,and after *** of PM parameters with Hct and reductions in Hct(ΔHct)were also ***:Before CPB,patients with cyanotic CHD had lower MDPE and larger wobble than those with acyanotic CHD,although mean ScO_(2)did not differ significantly between the two *** CPB,ScO_(2)of acyanotic CHD increased asΔHct increased,but PM variables were not associated withΔ*** cyanotic CHD,MDPE(r=−0.324,p=0.032)and MDAPE(r=0.339,p=0.024)correlated significantly withΔHct during *** CPB,MDPE(r=0.574,p=0.025)and MDAPE(r=−0.543,p=0.036)were significantly correlated with Hct in children with cyanotic CHD who underwent palliative ***:Therefore,ScO_(2)fluctuation during CPB in children with cyanotic CHD may be affected by the decrease in Hct,suggesting that excessive hemodilution can negatively influence the maintenance of cerebral oxygenation in these patients.