title: Correlation between cerebral-renal near-infrared spectroscopy and ipsilateral renal perfusion parameters as clinical outcome predictors after open heart surgery in neonates and infants.
abstract: The objective of this clinical study is to determine whether correlation exists among cerebral and renal near-infrared spectroscopy (NIRS) measurements, renal Doppler ultrasonography parameters (resistive index, peak systolic velocity), and early postoperative clinical outcomes following cardiac surgery in neonates and infants. Thirty-seven patients undergoing surgery for congenital heart defects with an age of less than 3 months, all of whom were in the high-risk group according to Aristotle Basic Complexity risk stratification score, were enrolled in our study. Cerebral, renal NIRS values and renal Doppler ultrasonography measurements were recorded for each patient at the 4th postoperative hour. The renal resistive indices were calculated for each case, and the patients were divided into two groups according to renal resistive index (RI) values. Group I included the patients with a RI of greater than 0.8 (n = 25) and Group II included the patients with a RI of less than 0.8 (n = 12). The postoperative outcome parameters were compared in between two groups. Group I (RI >0.8) had lower postoperative mean urine output than Group II (RI <0.8) (P = 0.041). The lactate levels were significantly higher in Group I (P = 0.049), as well. The postoperative intensive care unit and hospital stay of Group I was significantly higher than Group II (P = 0.048). Both cerebral and renal NIRS values and the assessment of renal RI as well as peak systolic values can be used in order to predict the early clinical outcome in cardiac surgery patients in early infantile and neonatal period.
authors.affiliation: Department of Radiology, Istanbul Medipol University, Istanbul, Turkey.
authors.forename: Tuğrul
authors.initials: T
authors.lastname: Örmeci
authors.forename: Tijen
authors.initials: T
authors.lastname: Alkan-Bozkaya
authors.forename: Arda
authors.initials: A
authors.lastname: Özyüksel
authors.forename: Cihangir
authors.initials: C
authors.lastname: Ersoy
authors.forename: Akif
authors.initials: A
authors.lastname: Ündar
authors.forename: Atıf
authors.initials: A
authors.lastname: Akçevin
authors.forename: Halil
authors.initials: H
authors.lastname: Türkoğlu
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods / Q000401:mortality; D002315:Cardiopulmonary Bypass / Q000379:methods* / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D011237:Predictive Value of Tests; D012079:Renal Circulation / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D015996:Survival Rate; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D014188:Transposition of Great Vessels / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods*
keywords: Cardiopulmonary bypass; Doppler ultrasonography; Infant; Near-infrared spectroscopy; Newborn; Renal blood flow