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Association of Early Postoperative Regional Oxygen Saturation Measures and Development of Necrotizing Enterocolitis in Neonates Following Cardiac Surgery

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Abstract

Necrotizing enterocolitis (NEC) is a relatively common complication in neonates with single ventricle physiology following heart surgery. Near-infrared spectroscopy (NIRS) is used to measure regional oxygen saturations in neonates in the postoperative period. We sought to investigate the association of somatic regional oxygen saturation (srSO2) and cerebral regional oxygen saturation (crSO2) in the early postoperative period and the subsequent development of NEC. We performed a retrospective cohort study of neonates who underwent cardiac surgery with cardiopulmonary bypass from October 2017 to September 2021 at the University of Virginia Children’s Hospital. Values of srSO2 and crSO2 were captured over the first 48 h following surgery. 166 neonates were included and the median age at time of surgery was 8 days. NEC was diagnosed in 18 neonates following heart surgery with a median interval from surgery to diagnosis of 7 days. Neonates with single ventricle physiology had lower average crSO2 (62% vs 78%, p < 0.001), average srSO2 (72% vs 86%, p < 0.001), average crSO2 to srSO2 ratio (0.874 vs 0.913, p < 0.001), and an increased average srSO2–crSO2 difference (10% vs 8%, p = 0.03). Adjusting for single ventricle physiology, lower average crSO2 was associated with the development of definite NEC (modified Bell’s criteria stage IIa and higher) (OR = 0.86, 95% CI 0.78–0.96, p = 0.007). Lower crSO2 values in the early postoperative period in neonates following cardiac surgery was associated with an increased risk in the subsequent development of NEC.

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Authors and Affiliations

  1. Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

    Augustin J. Casals & Michael C. Spaeder

  2. Division of Pediatric Critical Care, University of Virginia School of Medicine, Box 800386, Charlottesville, VA, 22908, USA

    Michael C. Spaeder

  3. Center for Advanced Medical Analytics, University of Virginia School of Medicine, Charlottesville, VA, USA

    Michael C. Spaeder

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Augustin Casals prepared the main manuscript text. Michael Spaeder prepared the methods, results, tables 1-2 and reviewed the manuscript.

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Correspondence to Michael C. Spaeder.

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Casals, A.J., Spaeder, M.C. Association of Early Postoperative Regional Oxygen Saturation Measures and Development of Necrotizing Enterocolitis in Neonates Following Cardiac Surgery. Pediatr Cardiol 45, 690–694 (2024). https://doi.org/10.1007/s00246-023-03117-w

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  • DOI: https://doi.org/10.1007/s00246-023-03117-w

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