Abstract
Congenital heart disease (CHD) patients are at risk for neurodevelopmental delay. The etiology of these delays is unclear, but abnormal prenatal cerebral maturation and postoperative hemodynamic instability likely play a role. A better understanding of these factors is needed to improve neurodevelopmental outcome. In this study, we used bedside frequency-domain near infrared spectroscopy (FDNIRS) and diffuse correlation spectroscopy (DCS) to assess cerebral hemodynamics and oxygen metabolism in neonates with single-ventricle (SV) CHD undergoing surgery and compared them to controls. Our goals were 1) to compare cerebral hemodynamics between unanesthetized SV and healthy neonates, and 2) to determine if FDNIRS-DCS could detect alterations in cerebral hemodynamics beyond cerebral hemoglobin oxygen saturation (SO 2). Eleven SV neonates were recruited and compared to 13 controls. Preoperatively, SV patients showed decreased cerebral blood flow (CBFi ), cerebral oxygen metabolism (CMRO 2i ) and SO 2; and increased oxygen extraction fraction (OEF) compared to controls. Compared to preoperative values, unstable postoperative SV patients had decreased CMRO 2i and CBFi , which returned to baseline when stable. However, SO 2 showed no difference between unstable and stable states. Preoperative SV neonates are flow-limited and show signs of impaired cerebral development compared to controls. FDNIRS-DCS shows potential to improve assessment of cerebral development and postoperative hemodynamics compared to SO 2 alone.
Highlights
Congenital heart disease (CHD) is the most common birth defect, affecting nearly 1 in every 100 children [1]
Gender and gestational age (GA) were significantly lower in SV neonates versus controls, but GA only differed by 0.5 weeks
Preoperative (n = 13) Unstable (n = 17) Stable (n = 34) Linear fit. In this prospective observational study, we confirmed that unanesthetized SV neonates had diminished cerebral blood flow index (CBFi) compared to healthy newborns [22] and showed that CMRO2i was lower in unanesthetized SV patients compared to typical developing controls
Summary
Congenital heart disease (CHD) is the most common birth defect, affecting nearly 1 in every 100 children [1]. Neurodevelopmental outcomes are characterized by a diverse spectrum of developmental delays and disabilities including impaired executive functions with the prevalence and severity increasing with the complexity of the CHD [3,4,5,6,7]. The etiology of these neurodevelopmental disorders is complex and several variables including pre-existing brain abnormalities and evolving factors in the perioperative period are believed to play a significant role [8,9,10,11]. The focus of neurodevelopmental studies was initially placed on the operative time period, preoperative brain abnormalities and early postoperative hemodynamic instability are likely to play a significant role in later neurodevelopmental impairment [12,13,14,15,16,17]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
