Open Access

ARTICLE

Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in Young Infants

by Hwa-Young Jang¹, Sang-Jun Beon², Sung-Hoon Kim¹, In-Kyung Song¹, Won-Jung Shin^1,*

1 Department of Anesthesiology and Pain Medicine, Laboratory for Cardiovascular Dynamics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
2 Department of Physician Education and Training, Asan Medical Center, Seoul, 05505, Korea

* Corresponding Author: Won-Jung Shin. Email:

Congenital Heart Disease 2023, 18(6), 639-647. https://doi.org/10.32604/chd.2023.030065

Received 21 March 2023; Accepted 24 October 2023; Issue published 19 January 2024

Abstract

Objectives: We investigated whether the selective cerebral perfusion (SCP) technique causes differences in changes in cerebral perfusion between both hemispheres in young infants, using cerebral oxygen saturation (ScO₂) as an index. Further, we determined the association between the discrepancy in ScO₂ and cerebral perfusion pressure during SCP. Methods: The difference in ScO₂ between the left and right cerebral hemispheres (ΔScO_{2 Rt-Lt}) was calculated during clamping of the innominate artery (IA) and during SCP. Results: In 25 infants (aged 2 to 78 days), the left and right ScO₂ were well maintained (median 63.2% and 60.9% during IA clamping, respectively; 64.0% and 65.6% during SCP, respectively). During IA clamping, right and left ScO₂ decreased (median −1.4% and −1.0%, respectively). During SCP, right ΔScO₂ was higher compared to left ΔScO₂ (median 1.5% vs. 0.6%; p < 0.001). Eight patients had a higher right ΔScO₂ than left ΔScO₂ throughout SCP. They had lower ΔScO_{2 Rt-Lt} during IA clamping (median −3.2% vs. 0.0%; p < 0.001) and higher ΔScO_{2 Rt-Lt} during SCP than others (median 5.0% vs. −0.8%; p < 0.001). During and after SCP, the correlation coefficient between right ΔScO₂ and change in the mean arterial pressure was higher in patients with a discrepancy than in others (r = 0.731 vs. r = 0.519; p < 0.001). Conclusions: This study suggests that SCP permits adequate bilateral cerebral perfusion. However, the unilateral cerebral perfusion technique may cause a difference in cerebral perfusion between both hemispheres in young infants; this may depend on the perfusion pressure.

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Graphic Abstract

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