PhD Scientific Days 2023
Budapest, 22-23 June 2023
Clinical Medicine - Posters J
Synchronous cerebral rSO2 and mean arterial pressure changes in neonates undergoing general anesthesia
Előadó neve
Dr. Trinh, Sarolta
Neptun code
hpi45y
Előadó munkahelye
Department of Paediatrics
Előadó telefonszáma
+36208038003
Előadó e-mail címe
trinh.sarolta.haiyen@semmelweis.hu
Az előadás címe
Synchronous cerebral rSO2 and mean arterial pressure changes in neonates undergoing general anesthesia
Szerző(k) neve és munkahelye
Sarolta Trinh1, Vera Balog1, Magdolna Barra2, Luca Bogner1, Melinda Kis-Tamas3, Balazs Hauser3, Agnes Jermendy1
1Division of Neonatology, Department of Pediatrics, Semmelweis University, Budapest
2Department of Nuclear Medicine, Semmelweis University, Budapest
3Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest
Bemutatás módja
Poszter
Szekció
Clinical Medicine - Posters J
Language of the presentation
English
Preferred session
Clinical Medicine
Összefoglaló szövege
Introduction, aims, hypothesis: Hemodynamic instability is a critical event and a common finding during neonatal general anesthesia. Addition of NIRS (near-infrared spectroscopy) to the standard monitoring of vital parameters may help preventing or mitigating adverse events. NIRS provides real time information about regional cerebral tissue oxygenation (rSO2), which is mainly influenced by blood pressure (BP), peripheral oxygen saturation (SpO2), heart rate, and partial CO2 tension (pCO2).
We aimed to assess the episodes of low cerebral oxygenation and its relation to low BP in a tertiary neonatal surgical center.
Methods: In this observational prospective study between June 2021 to February 2023, we enrolled 92 infants (55 premature and 37 term neonates) undergoing general anesthesia for surgery. The rSO2 was registered using Medtronic, INVOS 5100C NIRS monitor, with 5 s sampling interval and 1 min average values. Decreased rSO2 levels were defined by <70%. For hypotension for <7 days old preterm infants mean arterial pressure (MAP) was defined less than their gestational age in weeks, in infants >7 days old MAP was adjusted to recommendations by J. de Graaff. Data is in median [IQR] or number (%).
Results: Median bodyweight of premature patients was 2.1 [1.6;3.0] kg and term neonates were 3.3 [2.8;3.6] kg. A total of 8931 mins were recorded. Median length of anesthesia was 97 [60;133] mins. The total time spent in low rSO2 range was 44% of total anesthesia time in preterm and was 34% in term neonates (p<0.001). MAP and rSO2 showed a slight positive correlation in the whole study population (r=0.24). In premature infants, synchronous MAP and rSO2 decrease was observed in 26% of the total recorded time, while ‘isolated’ hypotension, without rSO2 or SpO2 changes occurred in 19% of time. In contrast, we observed opposite trends in term neonates, where these rates were 14% and 27%, respectively.
Discussion: Our data shows that rSO2 decrease is frequent during neonatal anesthesia, suggesting that it is prudent to use NIRS monitoring in this patient population. Interestingly, in term neonates 'isolated' hypotension without rSO2 change occurred 20% of the time, a finding of high clinical relevance that warrants further investigation.
Funding: Semmelweis Excellence 250+, OTKA FK_20 135222 és RRF-2.3.1-21-2022-00011
University and Doctoral School
Semmelweis University, Károly Rácz Doctoral School of Clinical Medicine
Supervisor
Agnes Jermendy
Publication of my abstract
I do not give consent to the publication of my abstract on the website of the congress.
Kind
Szabad
Status
elfogadva
Accepted presentation method
poszter
Előadás fájl jóváhagyás
nem rendelkezett róla
Előadó
6843
Start
10:42
End
10:47
Authors (legacy)
Sarolta Trinh1, Vera Balog1, Magdolna Barra2, Luca Bogner1, Melinda Kis-Tamas3, Balazs Hauser3, Agnes Jermendy1
1Division of Neonatology, Department of Pediatrics, Semmelweis University, Budapest
2Department of Nuclear Medicine, Semmelweis University, Budapest
3Department of Anesthesiology and Intensive Therapy, Semmelweis University, Budapest