OBJECTIVE: The early postoperative period following neonatal cardiac surgery is a time of increased risk for brain injury, yet the mechanisms underlying this risk are unknown. To understand these risks more completely, we quantified changes in postoperative cerebral metabolic rate of oxygen (CMRO(2)), oxygen extraction fraction (OEF), and cerebral blood flow (CBF) compared with preoperative levels by using noninvasive optical modalities. METHODS: Diffuse optical spectroscopy and diffuse correlation spectroscopy were used concurrently to derive cerebral blood flow and oxygen utilization postoperatively for 12 hours. Relative changes in CMRO(2), OEF, and CBF were quantified with reference to preoperative data. A mixed-effect model was used to investigate the influence of total support time and deep hypothermic circulatory arrest duration on relative changes in CMRO(2), OEF, and CBF. RESULTS: Relative changes in CMRO(2), OEF, and CBF were assessed in 36 patients, 21 with single-ventricle defects and 15 with 2-ventricle defects. Among patients with single-ventricle lesions, deep hypothermic circulatory arrest duration did not affect relative changes in CMRO(2), CBF, or OEF (P > .05). Among 2-ventricle patients, total support time was not a significant predictor of relative changes in CMRO(2) or CBF (P > .05), although longer total support time was associated significantly with greater increases in relative change of postoperative OEF (P = .008). CONCLUSIONS: Noninvasive diffuse optical techniques were used to quantify postoperative relative changes in CMRO(2), CBF, and OEF for the first time in this observational pilot study. Pilot data suggest that surgical duration does not account for observed variability in the relative change in CMRO(2), and that more comprehensive clinical studies using the new technology are feasible and warranted to elucidate these issues further.
OBJECTIVE: The early postoperative period following neonatal cardiac surgery is a time of increased risk for brain injury, yet the mechanisms underlying this risk are unknown. To understand these risks more completely, we quantified changes in postoperative cerebral metabolic rate of oxygen (CMRO(2)), oxygen extraction fraction (OEF), and cerebral blood flow (CBF) compared with preoperative levels by using noninvasive optical modalities. METHODS: Diffuse optical spectroscopy and diffuse correlation spectroscopy were used concurrently to derive cerebral blood flow and oxygen utilization postoperatively for 12 hours. Relative changes in CMRO(2), OEF, and CBF were quantified with reference to preoperative data. A mixed-effect model was used to investigate the influence of total support time and deep hypothermic circulatory arrest duration on relative changes in CMRO(2), OEF, and CBF. RESULTS: Relative changes in CMRO(2), OEF, and CBF were assessed in 36 patients, 21 with single-ventricle defects and 15 with 2-ventricle defects. Among patients with single-ventricle lesions, deep hypothermic circulatory arrest duration did not affect relative changes in CMRO(2), CBF, or OEF (P > .05). Among 2-ventricle patients, total support time was not a significant predictor of relative changes in CMRO(2) or CBF (P > .05), although longer total support time was associated significantly with greater increases in relative change of postoperative OEF (P = .008). CONCLUSIONS: Noninvasive diffuse optical techniques were used to quantify postoperative relative changes in CMRO(2), CBF, and OEF for the first time in this observational pilot study. Pilot data suggest that surgical duration does not account for observed variability in the relative change in CMRO(2), and that more comprehensive clinical studies using the new technology are feasible and warranted to elucidate these issues further.
Authors: Jia Li; Gencheng Zhang; Brian W McCrindle; Helen Holtby; Tilman Humpl; Sally Cai; Christopher A Caldarone; Andrew N Redington; Glen S Van Arsdell Journal: J Thorac Cardiovasc Surg Date: 2007-02 Impact factor: 5.209
Authors: Stephanie Fuller; Ramakrishnan Rajagopalan; Gail P Jarvik; Marsha Gerdes; Judy Bernbaum; Gil Wernovsky; Robert R Clancy; Cynthia Solot; Susan C Nicolson; Thomas L Spray; J William Gaynor Journal: Ann Thorac Surg Date: 2010-12 Impact factor: 4.330
Authors: Dean B Andropoulos; Jill V Hunter; David P Nelson; Stephen A Stayer; Ann R Stark; E Dean McKenzie; Jeffrey S Heinle; Daniel E Graves; Charles D Fraser Journal: J Thorac Cardiovasc Surg Date: 2009-11-11 Impact factor: 5.209
Authors: Jodi Chen; Robert A Zimmerman; Gail P Jarvik; Alex S Nord; Robert R Clancy; Gil Wernovsky; Lisa M Montenegro; Diane M Hartman; Susan C Nicolson; Thomas L Spray; J William Gaynor; Rebecca Ichord Journal: Ann Thorac Surg Date: 2009-09 Impact factor: 4.330
Authors: Kristin K Galli; Robert A Zimmerman; Gail P Jarvik; Gil Wernovsky; Marijn K Kuypers; Robert R Clancy; Lisa M Montenegro; William T Mahle; Mark F Newman; Ann M Saunders; Susan C Nicolson; Thomas L Spray; J William Gaynor; Kristen K Galli Journal: J Thorac Cardiovasc Surg Date: 2004-03 Impact factor: 5.209
Authors: Daniel J Licht; David M Shera; Robert R Clancy; Gil Wernovsky; Lisa M Montenegro; Susan C Nicolson; Robert A Zimmerman; Thomas L Spray; J William Gaynor; Arastoo Vossough Journal: J Thorac Cardiovasc Surg Date: 2009-03 Impact factor: 5.209
Authors: Mathieu Dehaes; Henry H Cheng; Erin M Buckley; Pei-Yi Lin; Silvina Ferradal; Kathryn Williams; Rutvi Vyas; Katherine Hagan; Daniel Wigmore; Erica McDavitt; Janet S Soul; Maria Angela Franceschini; Jane W Newburger; P Ellen Grant Journal: Biomed Opt Express Date: 2015-11-09 Impact factor: 3.732
Authors: Varsha Jain; Erin M Buckley; Daniel J Licht; Jennifer M Lynch; Peter J Schwab; Maryam Y Naim; Natasha A Lavin; Susan C Nicolson; Lisa M Montenegro; Arjun G Yodh; Felix W Wehrli Journal: J Cereb Blood Flow Metab Date: 2013-12-11 Impact factor: 6.200
Authors: Jennifer M Lynch; Tiffany Ko; David R Busch; John J Newland; Madeline E Winters; Kobina Mensah-Brown; Timothy W Boorady; Rui Xiao; Susan C Nicolson; Lisa M Montenegro; J William Gaynor; Thomas L Spray; Arjun G Yodh; Maryam Y Naim; Daniel J Licht Journal: J Thorac Cardiovasc Surg Date: 2018-05-03 Impact factor: 5.209
Authors: Wesley B Baker; Ashwin B Parthasarathy; Kimberly P Gannon; Venkaiah C Kavuri; David R Busch; Kenneth Abramson; Lian He; Rickson C Mesquita; Michael T Mullen; John A Detre; Joel H Greenberg; Daniel J Licht; Ramani Balu; W Andrew Kofke; Arjun G Yodh Journal: J Cereb Blood Flow Metab Date: 2017-05-25 Impact factor: 6.200
Authors: Juliette Selb; Kuan-Cheng Wu; Jason Sutin; Pei-Yi Ivy Lin; Parisa Farzam; Sophia Bechek; Apeksha Shenoy; Aman B Patel; David A Boas; Maria Angela Franceschini; Eric S Rosenthal Journal: Neurophotonics Date: 2018-11-13 Impact factor: 3.593
Authors: Joshua C Grimm; J Trent Magruder; Mary A Wilson; Mary E Blue; Todd C Crawford; Juan C Troncoso; Fan Zhang; Sujatha Kannan; Christopher M Sciortino; Michael V Johnston; Rangaramanujam M Kannan; William A Baumgartner Journal: Ann Thorac Surg Date: 2016-05-04 Impact factor: 4.330
Authors: Detian Wang; Ashwin B Parthasarathy; Wesley B Baker; Kimberly Gannon; Venki Kavuri; Tiffany Ko; Steven Schenkel; Zhe Li; Zeren Li; Michael T Mullen; John A Detre; Arjun G Yodh Journal: Biomed Opt Express Date: 2016-02-03 Impact factor: 3.732
Authors: Constantine D Mavroudis; Kobina G Mensah-Brown; Tiffany S Ko; Timothy W Boorady; Shavonne L Massey; Nicholas S Abend; Susan C Nicolson; Ryan W Morgan; Christopher E Mascio; J William Gaynor; Todd J Kilbaugh; Daniel J Licht Journal: Ann Thorac Surg Date: 2018-07-30 Impact factor: 4.330
Authors: David R Busch; Craig G Rusin; Wanda Miller-Hance; Kathy Kibler; Wesley B Baker; Jeffrey S Heinle; Charles D Fraser; Arjun G Yodh; Daniel J Licht; Kenneth M Brady Journal: Biomed Opt Express Date: 2016-08-15 Impact factor: 3.732