Esophageal saturation during antegrade cerebral perfusion: A preliminary report using visible light spectroscopy

Carly Heninger, Chandra Ramamoorthy*, Gabriel Amir, Komal Kamra, V. Mohan Reddy, Frank L. Hanley, John G. Brock-Utne

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Visible light spectroscopy (VLS) is newer technology that measures real-time tissue oxygenation. It has been validated in detecting mucosal ischemia in adults. During complex neonatal heart surgery, antegrade cerebral perfusion (ACP) maintains cerebral saturation. Whether ACP maintains peripheral tissue perfusion in humans is not known. Methods: Five patients undergoing neonatal open heart surgery with hypothermic cardiopulmonary bypass (CPB) were studied using a VLS esophageal probe in addition to bilateral near infrared cerebral oximetry. Three of five patients required ACP for arch repair, while two patients did not. VLS and cerebral saturation data were collected and analyzed in 5 min intervals prior to CPB, during CPB, and during ACP. Results: In the two patients undergoing heart surgery with routine hypothermic CPB, both cerebral and esophageal saturations were maintained. However in all three neonates requiring ACP, although cerebral saturations did not decrease, esophageal saturation fell below the ischemic threshold (35%). Following establishment of normal CPB, esophageal saturation returned to baseline. Conclusions: Antegrade cerebral perfusion maintains cerebral oxygen delivery, however, it does not adequately perfuse the esophagus in neonates. This could have clinical implications.

Original languageEnglish
Pages (from-to)1133-1137
Number of pages5
JournalPaediatric Anaesthesia
Volume16
Issue number11
DOIs
StatePublished - Nov 2006
Externally publishedYes

Keywords

  • Cardiopulmonary bypass
  • Children: somatic perfusion
  • Near infrared cerebral oximetry
  • Open heart surgery
  • Visible light spectroscopy

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