The significance of baseline cerebral oxygen saturation in children undergoing congenital heart surgery

Abstract Objectives Despite recent significant improvement in outcome, children undergoing surgery for correction of congenital heart defects have a persistent and troublesome mortality rate and incidence of neurologic complications. Recent data suggest that some congenital heart defects are associated with abnormal brain development and with low cerebral blood flow. We hypothesized that some children with congenital heart disease have an abnormally low baseline (preoperative) cerebral oxygen saturation (ScO 2 ). Methods ScO 2 was continuously recorded intraoperatively in 143 infants and children (age Results Patient age ranged from 2 days to 17 years (median 8 months). Mean baseline ScO 2 was 64%. Preoperative ScO 2 was lower in infants with left to right shunt physiology ( P Conclusions Baseline ScO 2 is lower in patients with left-to-right shunt physiology. Postoperative saturation is lower in patients with left-to-right shunt physiology and in cyanotic patients. Low baseline ScO 2 predicts perioperative mortality in children with congenital heart disease. Measurement of ScO 2 preoperatively will provide additional information for parent counseling, and preoperative optimization of ScO 2 may improve outcome.