Evaluation of brain function in adult patent ductus arteriosus surgery: A multimodal monitoring approach
Current Problems in Cardiology(2024)
Abstract
Adult patent ductus arteriosus (PDA) repair surgery often involves hypothermic cardiopulmonary bypass (CPB) and is associated with postoperative neurological complications. Our study evalu-ates brain function during PDA surgery using regional cerebral oxygen saturation (rSO2) and bispectral index (BIS) monitoring to mitigate these complications. Patients were categorized into moderate (26-31 'C) and mild (32-35 'C) hypothermia groups. Findings indicate a positive correlation between PDA diameter and pulmonary artery systolic blood pressure, and a strong correlation between delirium and average rSO2-AUC. The mild hypothermia group had longer extubation and hospitalization times. During CPB, rSO2 levels fluctuated significantly, and EEG analysis revealed changes in brain wave patterns. One case of nerve injury in the mild hypo-thermia group showed incomplete recovery after a year. Our results advocate for moderate hy-pothermia during CPB in adult PDA repair, suggesting that combined rSO2 and BIS monitoring can reduce neurological complications post-surgery.
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Key words
Patent ductus arteriosus (PDA),Cerebral oxygen saturation,Bispectral index (BIS),Hypothermia,Low flow,Cardiopulmonary bypass
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