Can Cerebral Oximetry Near-Infrared Spectroscopy Strategy in Hypothermic Cardiopulmonary Bypass in Congenital Cardiac Surgery be Considered an Advanced Nursing Practice?
-
Maryam Shakiba
,
Mahmood Hosseinzadeh Maleki
,
Ghazaleh Khademian
,
Amene Ghanbari
,
Fatemeh Hajipour
,
Mohamad Amin Younessi Heravi
,
Saeideh Imani Moghaddam
,
Mohsen Yaghubi
Abstract
Background: The importance of cerebral perfusion during congenital cardiac surgery, especially after hypothermic cardiopulmonary bypass (CPB) strategy, has remained a debate. In this study, we evaluated the effect of mild hypothermic CPB strategy on cerebral oximetry near-infrared spectroscopy in congenital heart defects surgery.
Methods: In a randomized prospective study, the pediatrics aged two months and six years with RACHS categories I-Ⅱ for congenital heart defects surgery were randomly divided into normothermic and mild hypothermic CPB groups. The NIRS was measured in all patients via the INVOS ™ cerebral oximetry system. The perfusion and anesthesia strategies during the study were followed as standard methods. A p-value below 0.05 is considered to be a significant level.
Results: Regarding cerebral oximetry, the results showed no significant difference between normothermic and mild hypothermic CPB groups.
Conclusion: It can be concluded that optimizing cerebral oxygen saturation monitoring during congenital cardiac surgery can improve patient outcomes as a protective strategy.
[1] Fathi M, Valaei M, Ghanbari A, Ghasemi R, Yaghubi M. Comparison of Patient's Kidney Function Based on Kidney Disease Improving Global Outcomes (KDIGO) Criteria and Clinical Parameters in Isolated Coronary Artery Bypass Graft (CABG) Surgery in On-Pump and Off-pump Methods in Patients with Low Cardiac Output Syndrome (LCOS) After Surgery. Anesth Pain Med. 2020; 10(2):e100517.
[2] Arki M, Moeinipour A, Fathi M, Abbasi Teshnizi M, Pasandi H, Heydari M. The effects of St. Thomas I and St. Thomas II Cardioplegia solutions on coronary sinus lactate in mitral valve surgery; A Randomized, Double-blinded, Clinical Trial. Razavi Int J Med. 2023; 11(3): 12-16.
[3] Amouzeshi A, Amouzeshi Z, Abbasi Teshnizi M, Moeinipour AA, Hosseinzadeh Maleki M. Off-Pump Versus On-Pump Coronary Artery Bypass Graft Surgery Outcomes During 6 Years: A Prospective Cohort Study. Acta Med Iran. 2017; 55(9):578-584.
[4] Hatami F, Valizadeh N, Salehi F, Hosseinzadeh Maleki M. Topical versus low-dose systemic tranexamic acid in pediatric cardiac surgery: A randomized clinical study. J Card Surg. 2020; 35(12):3368-3373.
[5] Bianco V, Kilic A, Aranda-Michel E, Dunn-Lewis C, Serna-Gallegos D, Chen S, et al. Mild hypothermia versus normothermia in patients undergoing cardiac surgery. JTCVS Open. 2021; 7:230-242.
[6] Ali J, Cody J, Maldonado Y, Ramakrishna H. Near-Infrared Spectroscopy (NIRS) for Cerebral and Tissue Oximetry: Analysis of Evolving Applications. J Cardiothorac Vasc Anesth. 2022; 36(8 Pt A):2758-2766.
[7] Loomba RS, Rausa J, Sheikholeslami D, Dyson AE, Farias JS, Villarreal EG, et al. Correlation of Near-Infrared Spectroscopy Oximetry and Corresponding Venous Oxygen Saturations in Children with Congenital Heart Disease. Pediatr Cardiol. 2022; 43(1):197-206.
[8] Rescoe E, Tang X, Perry DA, Sleeper LA, DiNardo JA, Kussman BD, et al. Cerebral near-infrared spectroscopy insensitively detects low cerebral venous oxygen saturations after stage 1 palliation. J Thorac Cardiovasc Surg. 2017; 154(3):1056-1062.
[9] Xiong T, Pu L, Ma YF, Zhu YL, Cui X, Li H, et al. Safety of Normothermic Cardiopulmonary Bypass in Pediatric Cardiac Surgery: A System Review and Meta-Analysis. Front Pediatr. 2021; 9:757551.
[10] Floh AA, Das S, Haranal M, Laussen PC, Crawford-Lean L, Fan CS, et al. Comparison between Del Nido and conventional blood cardioplegia in pediatric open-heart surgery. Perfusion. 2023; 38(2):337-345.
[11] Haranal M, Chin HC, Sivalingam S, Raja N, Mohammad Shaffie MS, Namasiwayam TK, et al. Safety and Effectiveness of Del Nido Cardioplegia in Comparison to Blood-Based St. Thomas Cardioplegia in Congenital Heart Surgeries: A Prospective Randomized Controlled Study. World J Pediatr Congenit Heart Surg. 2020; 11(6):720-726.
[12] Gagnon MH, Kussman BD, Zhou L, DiNardo JA, Kheir JN. Sensitivity of a Next-Generation NIRS Device to Detect Low Mixed Venous Oxyhemoglobin Saturations in the Single Ventricle Population. Anesth Analg. 2020; 131(3):e138-e141.
[13] Hogue CW, Levine A, Hudson A, Lewis C. Clinical Applications of Near-infrared Spectroscopy Monitoring in Cardiovascular Surgery. Anesthesiology. 2021; 134(5):784-791.
[14] Lozano-Vicario L, Zambom-Ferraresi F, Zambom-Ferraresi F, de la Casa-Marín A, Ollo-Martínez I, Sáez de Asteasu ML, et al. Effectiveness of a multicomponent exercise training program for the management of delirium in hospitalized older adults using near-infrared spectroscopy as a biomarker of brain perfusion: Study protocol for a randomized controlled trial. Front Aging Neurosci. 2022; 14:1013631.
[15] Easley RB, Marino BS, Jennings J, Cassedy AE, Kibler KK, Brady KM, et al. Impaired cerebral autoregulation and elevation in plasma glial fibrillary acidic protein level during cardiopulmonary bypass surgery for CHD. Cardiol Young. 2018; 28(1):55-65.
[2] Arki M, Moeinipour A, Fathi M, Abbasi Teshnizi M, Pasandi H, Heydari M. The effects of St. Thomas I and St. Thomas II Cardioplegia solutions on coronary sinus lactate in mitral valve surgery; A Randomized, Double-blinded, Clinical Trial. Razavi Int J Med. 2023; 11(3): 12-16.
[3] Amouzeshi A, Amouzeshi Z, Abbasi Teshnizi M, Moeinipour AA, Hosseinzadeh Maleki M. Off-Pump Versus On-Pump Coronary Artery Bypass Graft Surgery Outcomes During 6 Years: A Prospective Cohort Study. Acta Med Iran. 2017; 55(9):578-584.
[4] Hatami F, Valizadeh N, Salehi F, Hosseinzadeh Maleki M. Topical versus low-dose systemic tranexamic acid in pediatric cardiac surgery: A randomized clinical study. J Card Surg. 2020; 35(12):3368-3373.
[5] Bianco V, Kilic A, Aranda-Michel E, Dunn-Lewis C, Serna-Gallegos D, Chen S, et al. Mild hypothermia versus normothermia in patients undergoing cardiac surgery. JTCVS Open. 2021; 7:230-242.
[6] Ali J, Cody J, Maldonado Y, Ramakrishna H. Near-Infrared Spectroscopy (NIRS) for Cerebral and Tissue Oximetry: Analysis of Evolving Applications. J Cardiothorac Vasc Anesth. 2022; 36(8 Pt A):2758-2766.
[7] Loomba RS, Rausa J, Sheikholeslami D, Dyson AE, Farias JS, Villarreal EG, et al. Correlation of Near-Infrared Spectroscopy Oximetry and Corresponding Venous Oxygen Saturations in Children with Congenital Heart Disease. Pediatr Cardiol. 2022; 43(1):197-206.
[8] Rescoe E, Tang X, Perry DA, Sleeper LA, DiNardo JA, Kussman BD, et al. Cerebral near-infrared spectroscopy insensitively detects low cerebral venous oxygen saturations after stage 1 palliation. J Thorac Cardiovasc Surg. 2017; 154(3):1056-1062.
[9] Xiong T, Pu L, Ma YF, Zhu YL, Cui X, Li H, et al. Safety of Normothermic Cardiopulmonary Bypass in Pediatric Cardiac Surgery: A System Review and Meta-Analysis. Front Pediatr. 2021; 9:757551.
[10] Floh AA, Das S, Haranal M, Laussen PC, Crawford-Lean L, Fan CS, et al. Comparison between Del Nido and conventional blood cardioplegia in pediatric open-heart surgery. Perfusion. 2023; 38(2):337-345.
[11] Haranal M, Chin HC, Sivalingam S, Raja N, Mohammad Shaffie MS, Namasiwayam TK, et al. Safety and Effectiveness of Del Nido Cardioplegia in Comparison to Blood-Based St. Thomas Cardioplegia in Congenital Heart Surgeries: A Prospective Randomized Controlled Study. World J Pediatr Congenit Heart Surg. 2020; 11(6):720-726.
[12] Gagnon MH, Kussman BD, Zhou L, DiNardo JA, Kheir JN. Sensitivity of a Next-Generation NIRS Device to Detect Low Mixed Venous Oxyhemoglobin Saturations in the Single Ventricle Population. Anesth Analg. 2020; 131(3):e138-e141.
[13] Hogue CW, Levine A, Hudson A, Lewis C. Clinical Applications of Near-infrared Spectroscopy Monitoring in Cardiovascular Surgery. Anesthesiology. 2021; 134(5):784-791.
[14] Lozano-Vicario L, Zambom-Ferraresi F, Zambom-Ferraresi F, de la Casa-Marín A, Ollo-Martínez I, Sáez de Asteasu ML, et al. Effectiveness of a multicomponent exercise training program for the management of delirium in hospitalized older adults using near-infrared spectroscopy as a biomarker of brain perfusion: Study protocol for a randomized controlled trial. Front Aging Neurosci. 2022; 14:1013631.
[15] Easley RB, Marino BS, Jennings J, Cassedy AE, Kibler KK, Brady KM, et al. Impaired cerebral autoregulation and elevation in plasma glial fibrillary acidic protein level during cardiopulmonary bypass surgery for CHD. Cardiol Young. 2018; 28(1):55-65.
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How to Cite
1.
Shakiba M, Hosseinzadeh Maleki M, Khademian G, Ghanbari A, Hajipour F, Younessi Heravi MA, Imani Moghaddam S, Yaghubi M. Can Cerebral Oximetry Near-Infrared Spectroscopy Strategy in Hypothermic Cardiopulmonary Bypass in Congenital Cardiac Surgery be Considered an Advanced Nursing Practice?. Arch Anesth & Crit Care. 2024;.
