Correlation between blood lactate and regional cerebral oxygen saturation in complex cardiac pathology neonates and infants: The effect on extubation time and ICU stay

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dc.authorid0000-0002-5273-1871
dc.authorid0000-0002-0799-4875
dc.contributor.authorKaraaslan, Pelin
dc.contributor.authorÜnlükaplan, Aytekin
dc.contributor.authorVural Gökay, Banu
dc.contributor.authorDarçın, Kamil
dc.contributor.authorHızarcı, Burcu
dc.contributor.authorAlkan Bozkaya, Tijen
dc.contributor.authorÖzyüksel, Arda
dc.contributor.authorAkçevin, Atıf
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:37:28Z
dc.date.available10.07.201910:49:14
dc.date.available2019-07-10T19:37:28Z
dc.date.issued2017
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kalp ve Damar Cerrahisi Ana Bilim Dalı
dc.description.abstractBackground: The monitoring of regional cerebral O2 saturation (rSO2) with near-infrared spectroscopy (NIRS) is a noninvasive technique to measure tissue oxygenation in the brain. It may be an effective monitoring technique in the early diagnosis of pre-, intra- and post-operative insufficient oxygen supply to the brain in surgery for congenital heart diseases. In pediatric patients, a variety of clinical and laboratory parameters, including serum lactate and regional cerebral oxygen saturation, may be helpful in monitoring global tissue and cerebral oxygen delivery and consumption. Aim: Our study was designed to investigate whether there is a correlation between the NIRS scores and serum lactate levels during congenital heart surgery. Our secondary objective was to define the predictive value of this correlation on the duration of extubation and intensive care unit stay. Method: A total of 82 successive neonatal and infant patients with complex cardiac pathologies were enrolled in the study. Blood lactate levels and NIRS values were measured during the phases of anesthesia induction, sternotomy, cannulation, onset of CPB, the beginning of aortic cross-clamping and the end of the CPB. Study design: Prospective randomized Results: Patients with normal rSO2 /normal lactate during the operation represented the largest percentage of patients during anesthesia induction (n=50, 60.9%) and sternotomy (n=54, 65.8%). The only negative correlation between lactate and rSO2 was detected during anesthesia induction. The time to extubation and the stay in the intensive care unit were longer in patients with low rSO2 values during anesthesia induction and sternotomy. In the same periods, elevated lactate levels were associated with longer time to extubation and intensive care unit stay than the patients with normal lactate levels. Conclusion: In our study, no correlation was demonstrated between NIRS scores and serum lactate levels in children during congenital heart surgery, except for anesthesia induction. The only negative correlation between the decrease in NIRS scores and the increase in serum lactate levels was observed during anesthesia induction. This result indicated that cerebral NIRS monitoring cannot be used as an indicator of global hypoperfusion in the same way as lactate.
dc.identifier.citationKaraaslan, P., Ünlükaplan, A., Vural Gökay, B., Darçın, K., Hızarcı, B., Alkan Bozkaya, T. ... Akçevin, A. (2017). Correlation between blood lactate and regional cerebral oxygen saturation in complex cardiac pathology neonates and infants: The effect on extubation time and ICU stay. Biomedical Research (India), 28(7), 3101-3107.
dc.identifier.endpage3107
dc.identifier.issn0970-938X
dc.identifier.issn0976-1683
dc.identifier.issue7
dc.identifier.scopusqualityQ4
dc.identifier.startpage3101
dc.identifier.urihttps://hdl.handle.net/20.500.12511/1409
dc.identifier.volume28
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.language.isoen
dc.publisherScientific Publishers of India
dc.relation.ispartofBiomedical Research (India)en_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectCongenital Heart Diseases
dc.subjectLactate
dc.subjectNear Infrared Spectroscopy
dc.titleCorrelation between blood lactate and regional cerebral oxygen saturation in complex cardiac pathology neonates and infants: The effect on extubation time and ICU stay
dc.typeArticle

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