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Effects of different ventilation on cerebral oxygen saturation and cerebral blood flow before and after modified ultrafiltration in infants during ventricular septal defect repair

Part of: Echocardiography

Published online by Cambridge University Press:  05 February 2021

Boqun Cui ,
Chuan Ou-Yang ,
Siyuan Xie ,
Duomao Lin  and
Jun Ma Open the ORCID record for Jun Ma [Opens in a new window]
Boqun Cui
Affiliation:
Anesthesia Center, Capital Medical University affiliated Beijing An Zhen Hospital, Beijing, China
Chuan Ou-Yang
Affiliation:
Anesthesia Center, Capital Medical University affiliated Beijing An Zhen Hospital, Beijing, China
Siyuan Xie
Affiliation:
Anesthesia Center, Capital Medical University affiliated Beijing An Zhen Hospital, Beijing, China Department of Anesthesiology, Capital Institute of Pediatrics affiliated Children’s Hospital, Beijing, China
Duomao Lin
Affiliation:
Anesthesia Center, Capital Medical University affiliated Beijing An Zhen Hospital, Beijing, China
Jun Ma*
Affiliation:
Anesthesia Center, Capital Medical University affiliated Beijing An Zhen Hospital, Beijing, China
*
Address for correspondence: Jun Ma MD, Anesthesia Center, Capital Medical University affiliated Beijing An Zhen Hospital, Beijing, China. Tel: +860 106 445 6779; Fax: +860 106 445 6779. E-mail: majuntongxun@sohu.com
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Abstract

Objective:

To analyse the changes of different ventilation on regional cerebral oxygen saturation and cerebral blood flow in infants during ventricular septal defect repair.

Methods:

Ninety-two infants younger than 1 year were enrolled in the study. End-expiratory tidal pressure of carbon dioxide was maintained at 40–45 and 35–39 mmHg in relative low and high ventilation groups. Regional cerebral oxygen saturation and flow velocity of the middle cerebral artery were recorded after anaesthesia (T0), cut pericardium (T1), separation from cardiopulmonary bypass (T2), the end of modified ultrafiltration, (T3) and at the end of operation (T4).

Results:

The relative low ventilation group exhibited a significantly high regional cerebral oxygen saturation at each time point except for T2 (T0:77 ± 4, T1:76 ± 5, T3:76 ± 8, T4:76 ± 8, respectively, p < 0.001). Flow velocity of the middle cerebral artery in the relative low ventilation group was higher compared to the relative high ventilation group at each time point except for T2 (T0:53 ± 14, T1:54 ± 15, T3:53 ± 17, T4:52 ± 16, respectively, p < 0.001). Between the two groups, T2 showed the lowest middle cerebral artery flow velocity (relative low ventilation: 39 ± 15, relative high ventilation: 39 ± 11, p < 0.001).

Conclusion:

The infants’ regional cerebral oxygen saturation and middle cerebral artery flow velocity performed better in the range of 40–45 mmHg end-expiratory tidal pressure of carbon dioxide during CHD surgery. Modified ultrafiltration increased cerebral oxygen saturation. It was important to regulate ventilation in order to balance cerebral oxygen in infants.

Keywords

Ventilationend-expiratory tidal pressure of carbon dioxidecerebral oxygen saturationcerebral blood flowmodified ultrafiltrationventricular septal defectinfant
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 3 , March 2021 , pp. 371 - 376
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

Boqun Cui and Chuan Ou-Yang contributed equally to this work.

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