[Examination of the Influence of Age and Cardiopulmonary Bypass on Cerebral Autoregulation in Pediatric Patients for the Cardiac Surgery by Using Near-infrared Spectroscopy].

Abstract We evaluated the impact of age and cardiopulmonary bypass (CPB) on cerebral autoregulation in pediatric patients for the cardiac surgery with near-infrared spectroscopy. This retrospective study was conducted with 67 children undergoing closure of atrial or ventricular septal defects with CPB. The regression coefficient ((see symbol)regional cerebral oxygenation index ((see symbol)SO2)/ mean arterial blood pressure (mABP)) for each patient was calculated by simple regression analysis, assuming that higher regression coefficients indicate less functional cerebral autoregulation. In addition, to determine the vital parameters affecting rSO2 values during CPB, we analyzed the data from on-line continuous blood gas monitor with random effects-mixed model. The regression coefficients were frequently high among younger children (0-4 years), suggesting that the cerebral autoregulation was immature. Although regression coefficient values in younger children remained high through the operation, those in older children (5-14 years) increased significantly only during CPB, suggesting that cerebral autoregulation was dysfunctional during CPB. With random effects-mixed model, we revealed that mABP had the most significant effect on rSO2 values during CPB. Cerebral autoregulation in younger children is immature. Moreover, it does not work during CPB even in older children, and clinicians must ensure perfusion pressure carefully during CPB in pediatric patients.