Excerpt

The purpose of this study was to determine whether regional cerebral oxygen saturation (cSaO₂), measured by near-infrared spectroscopy (NIRS) technology, could predict the risk of adverse outcome after the Norwood procedure. The authors reviewed the first 48 hours of postoperative hemodynamic data on 50 patients with hypoplastic left heart syndrome who underwent the Norwood procedure. Cerebral oxygen saturation data within 48 hours of surgery were analyzed for association with subsequent adverse outcome, which was defined as intensive care unit length of stay greater than 30 days, need for extracorporeal membrane oxygenation, or hospital death after 48 hours. There were 18 adverse events among the 50 subjects. The mean cSaO₂ for the entire cohort at 1 hour, 4 hours, and 48 hours after surgery was 51% ± 7.5%, 50% ± 9.4%, and 59% ± 8.1%, respectively. Mean cSaO₂ for the first 48 postoperative hours of less than 56% was a risk factor for subsequent adverse outcome (odds ratio 11.9, 95% confidence interval: 2.5 to 55.8). Mean cerebral NIRS of less than 56% over the first 48 hours after surgery yielded a sensitivity of 75.0% and a specificity of 79.4% to predict those at risk for subsequent adverse events. …