Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries

Şerife Özalp; Ezgi Direnç Yücel; İncila Ali Kahraman; Selin Sağlam; Eymen Recep; Hatice Dilek Özcanoğlu; Erkut Özturk; Funda Gümüş Özcan; Ali Can Hatemi

doi:10.51645/khj.2025.488

Şerife Özalp^¹, Ezgi Direnç Yücel^¹, İncila Ali Kahraman^¹, Selin Sağlam^¹, Eymen Recep^², Hatice Dilek Özcanoğlu^¹, Erkut Özturk^³, Funda Gümüş Özcan^¹, Ali Can Hatemi^²

¹Department of Anesthesiology and Reanimation, İstanbul University of Health Sciences, Başakşehir Çam and Sakura Hospital, İstanbul, Türkiye
²Department of Pediatric Cardiac Surgery, İstanbul University of Health Sciences, Başakşehir Çam and Sakura Hospital, İstanbul, Türkiye
³Department of Pediatric Cardiology, İstanbul University of Health Sciences, Başakşehir Çam and Sakura Hospital, İstanbul, Türkiye

Keywords: Bispectral index; near-infrared spectroscopy; neuromonitoring; pediatric cardiac surgery.

Abstract

Objectives: The objective of this study was to evaluate the impact of combining near-infrared spectroscopy (NIRS) and bispectral index (BIS) for monitoring cerebral oxygenation and detecting ischemia during pediatric cardiac surgery with cardiopulmonary bypass (CPB).

Methods: A prospective, single-center study was conducted between March 01, 2024, and July 01, 2024, involving 50 pediatric patients undergoing congenital heart surgery. Cerebral oxygenation was continuously monitored using NIRS and BIS at 6 time points during surgery: T1 (entry), T2 (immediately after CPB initiation), T3 (deepest hypothermic temperature), T4 (post-rewarming), T5 (end of surgery), and T6 (postoperative intensive care unit [ICU]). Central venous saturation, hematocrit (Htc), temperature, mean arterial pressure (MAP), and lactate levels were also monitored. The primary outcomes included correlations between cerebral oxygenation parameters and neurological outcomes within 3 months.

Results: The study was conducted with a total of 50 children cases, of which 56% (n=28) were male, and 44% (n=22) were female. The age of the cases ranged from 6 to 200 months, with a mean 42.4±52.7 months. Weight measurements ranged from 14.2 to 65 kg, with a mean of 16.3±14.3 kg. The average CPB duration was 96.1±34.8 min. The cases had an average ICU stay of 3.2±2 days. Upon reviewing the final status, it was found that there were no mortality among the patients and only three patients experienced transient neurological complications, which resolved without long-term deficits. NIRS values remained stable between 55% and 65% during surgery. BIS monitoring detected no significant decreases, supporting the absence of severe ischemia.

Conclusion: Combining NIRS and BIS in pediatric cardiac surgery enhances cerebral perfusion monitoring and enables early detection of ischemic events, potentially reducing postoperative neurological complications. Larger studies are needed to validate these findings and further assess the role of intraoperative parameters such as Htc and MAP in preventing cerebral ischemia.

Cite This Article: Özalp Ş, Direnç Yücel E, Kahraman İA, Sağlam S, Recep E, Özcanoğlu HD, et al. Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries. Koşuyolu Heart J 2025;28(2):41–46

BibTex	@article{ kosuyolu_heart_j1946, doi = {10.51645/khj.2025.488}, author = {Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi}, title = {Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries}, journal = {Koşuyolu Heart J}, year = {2025}, volume = {28}, number = {2}, pages = {41-46}, publisher = {Kartal Koşuyolu High Specialization Training and Research Hospital} }
RIS	`TY - JOUR AU - Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi PY - 2025 TI - Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries SP - 41 EP - 46 JO - Koşuyolu Heart Journal J2 - Koşuyolu Heart J VL - 28 IS - 2 PB - DO - 10.51645/khj.2025.488 ER -`
EndNote	`%0 Journal Article %A Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi %T Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries %J Koşuyolu Heart Journal %D 2025 %V 28 %N 2 %P 41-46 %R 10.51645/khj.2025.488`
APA	Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi (2025). Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries. Koşuyolu Heart Journal, 28(2), 41-46. doi:10.51645/khj.2025.488
MLA	Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi. "Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries" Koşuyolu Heart Journal, vol. 28, no. 2, 2025, pp. 41-46. doi:10.51645/khj.2025.488.
Chicago	Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi. "Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries" Koşuyolu Heart Journal 28, no. 2 (2025): 41-46. https://doi.org/10.51645/khj.2025.488.
AMA	Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi. Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries. Koşuyolu Heart J. 2025; 28(2): 41-46. doi:10.51645/khj.2025.488.
Vancouver	Şerife Özalp, Ezgi Direnç Yücel, İncila Ali Kahraman, Selin Sağlam, Eymen Recep, Hatice Dilek Özcanoğlu, Erkut Özturk, Funda Gümüş Özcan, Ali Can Hatemi. Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries. Koşuyolu Heart J. 2025; 28(2): 41-46. doi:10.51645/khj.2025.488

Intraoperative Variables and Cerebral Oxygen Monitoring in Pediatric Cardiac Surgeries

Abstract

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