A Survey of the Congenital Cardiac Anesthesia Society on the Use and Clinical Application of Near- Infrared Tissue Oximetry in Pediatric Cardiac Surgery

Abstract

To better understand the patterns of use and the perceived utility of tissue oximetry in pediatric cardiac surgery. A voluntary 32-question Research Electronic Data Capture survey instrument was sent twice via e-mail to the entire Congenital Cardiac Anesthesia Society (CCAS) membership (January 13, 2021 and March 9,2021). International multi-institutional, universities, academic centers, and community hospitals. CCAS members. Not applicable. The survey was completed by 185 of 1,131 members (16.4% response rate). The majority of respondents (93.5%) reported use of tissue oximetry, with 97.1% reporting use for cardiac surgery with cardiopulmonary bypass, 76.3% for cardiac surgery without cardiopulmonary bypass, 34.7% in the cardiac catheterization laboratory, and 39.3% for major noncardiac surgeries. Only 14.5% reported that their institution had a formal near-infrared spectroscopy/tissue oximetry-based protocol. The most common sensor placement configuration was bilateral cerebral. More than 90% of respondents reported having made a clinical management change based on tissue oximetry values, although there was variability as to when respondents would intervene. The majority of respondents agreed or strongly agreed that tissue oximetry adds diagnostic value to standard intraoperative monitors, validates clinical observations, and aids in guiding patient management. Most, however, felt that tissue oximetry alone is not enough to inform management changes. Near-infrared spectroscopy-based tissue oximetry frequently used was by CCAS members, but with significant variations in clinical application.