Cerebral oximetry monitoring to maintain NORMal Cerebral Oxygen SATuration (NORMOSAT during high-risk cardiac surgery_ a randomized controlled feasibility trial

anaesthesia enabled sophisticated elaboration of recommendations and guidelines that resulted in significant fall of complications in the early postoperative period. Since the most important risk factors on adverse outcome following paediatric cardiac anaesthesia have been revealed, clinicans and researchers should identify those techniques and drugs that reduce the risk of minor complications.The present study makes an attempt to evaluate the impact of different types of inotropes administred intraoperatively on early postoperative outcome. Method. We retrospectively analysed the data of 1322 conscutive paediatric patients undergoing open heart surgery between 2005 and 2008 in a tertiary national cardiac institution. Patients’ baseline caracteristics (age, biometric and anamnestic data), type of surgery, pre-, intraand early postoperative (first 72 hours) clinical data were recorded. Independent samples t-test, oneway ANOVA, Bonferroni post-hoc test and multiple logistic regression modell was applied for statistical analysis. Results. Only epinephrine was administred to 40, only norepinephrine to 263, while both inotropes to 19 patients intraoperatively. Significant difference was observed in base excess, diuresis and maximal blood glucose on the day of surgery in the epinephrin-only versus the norepinephrine-only group (mean difference: 0.667; -9.83; -1.45; 1.80; 95% CI: 0.01-1.33; -19.600.06; -2.420.49; 0.882.71, respectively), while significantly higher CRP levels were measured in the epinephrine-olny group on the second postoperative day (mean difference: 23.31; 95% CI: 0.11-46.50). Only epinephrine administration intraoperatively was associated with higher risk for postoperative arrythmia (p1⁄40.05). This difference remained also in multivariate analysis. Discussion. According to our findings, intraoperative administration of epinephrine may have adverse effect on the early postoperative outcome. Large, pospective studies should be designed for further investigation of the issue.