Can Cerebral Oximetry Near-Infrared Spectroscopy Strategy in Hypothermic Cardiopulmonary Bypass in Congenital Cardiac Surgery be Considered an Advanced Nursing Practice?

Maryam  Shakiba; Mahmood  Hosseinzadeh Maleki; Ghazaleh  Khademian; Amene  Ghanbari; Fatemeh  Hajipour; Mohamad Amin Younessi Heravi; Saeideh Imani  Moghaddam; Mohsen  Yaghubi

doi:10.18502/aacc.v10is2.17217

Maryam Shakiba Department of Anesthesiology, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Mahmood Hosseinzadeh Maleki Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Ghazaleh Khademian Department of Critical Care, Razavi Hospital, Mashhad, Iran.
Amene Ghanbari Department of Extra-Corporeal Circulation (ECC), Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Fatemeh Hajipour Department of Extra-Corporeal Circulation (ECC), Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Mohamad Amin Younessi Heravi Department of Radiology and Medical Physics, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Saeideh Imani Moghaddam Department of Critical Care, Razavi Hospital, Mashhad, Iran.
Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Mashhad, Iran.

DOI: https://doi.org/10.18502/aacc.v10is2.17217

Keywords: Cardiopulmonary bypass; Cardiac surgery; Induced hypothermia; Near infra-red spectroscopy

Abstract

Background: The importance of cerebral perfusion during congenital cardiac surgery, especially after hypothermic cardiopulmonary bypass (CPB) strategy, has remained a debate. In this study, we evaluated the effect of mild hypothermic CPB strategy on cerebral oximetry near-infrared spectroscopy in congenital heart defects surgery.

Methods: In a randomized prospective study, the pediatrics aged two months and six years with RACHS categories I-Ⅱ for congenital heart defects surgery were randomly divided into normothermic and mild hypothermic CPB groups. The NIRS was measured in all patients via the INVOS ™ cerebral oximetry system. The perfusion and anesthesia strategies during the study were followed as standard methods. A p-value below 0.05 is considered to be a significant level.

Results: Regarding cerebral oximetry, the results showed no significant difference between normothermic and mild hypothermic CPB groups.

Conclusion: It can be concluded that optimizing cerebral oxygen saturation monitoring during congenital cardiac surgery can improve patient outcomes as a protective strategy.