Abstract 15672: Cerebral and Renal Saturation Trendings in Neonates With Congenital Heart Disease in the Pre-Intervention Period: A Prospective Study

Abstract

Introduction: Limited data exists on the trends of cerebral (CSat) and renal (RSat) saturations measured by near infrared spectroscopy (NIRS) of neonates with a congenital heart defect (CHD) during the first days of life in the pre-interventional setting. Hypothesis: We hypothesized that retrograde aortic flow in aorta as an indicator of diastolic steal would be associated with adverse CSat/Rsat profiles. Methods: We conducted a single-center prospective study recruiting newborns with CHD. CSat/ RSat were monitored until day 7 and averaged every hour. Daily echocardiograms were performed. Presence/ absence of holodiastolic retrograde flow in post-ductal aorta was assessed by an expert blinded to NIRS measurements and clinical status. Random mixed effect models were constructed to evaluate the association between NIRS trends and retrograde flow. Results: We included 49 newborns, of which 27 (55%) had retrograde flow. CSat remained stable throughout the monitoring period in the non-retrograde group, while it progressively declined in those with retrograde flow. An association was found between retrograde flow and negative trends CSat (β= -9.1%, 95%CI [-14.3 — -3.8]) and RSat (β= -8.4%, 95%CI [-14.5— -2.3]). Conclusions: In infants with CHD, retrograde flow in the descending aorta was associated with a CSat/RSat decline within the first week of life. Future studies should evaluate whether normalization of these parameters decreases the burden of neurological injury.