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Beth Ann Johnson, MD, George M. Hoffman, MD, James S

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1 Near-Infrared Spectroscopy in Neonates Before Palliation of Hypoplastic Left Heart Syndrome 
Beth Ann Johnson, MD, George M. Hoffman, MD, James S. Tweddell, MD, Joseph R. Cava, MD, PhD, Mir Basir, MD, Michael E. Mitchell, MD, Matthew C. Scanlon, MD, Kathleen A. Mussatto, BSN, PhDc, Nancy S. Ghanayem, MD  The Annals of Thoracic Surgery  Volume 87, Issue 2, Pages (February 2009) DOI: /j.athoracsur Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Respiratory variables in patients with near-infrared spectroscopy (NIRS) monitoring (dashed line) and without NIRS monitoring (solid line). The NIRS-monitored patients generally had higher SaO2 and PaO2, and lower PaCO2, owing to lower use of mechanical ventilation and less restrictive inspired gas management. (FiO2 = fraction of inspired oxygen.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Standard hemodynamic measurements in patients managed with (dashed line) and without (solid line) near-infrared spectroscopy (NIRS). There were no significant differences except for a reduction in creatinine in NIRS-monitored patients. (BP = blood pressure; ns = not significant.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Hemodynamics in near-infrared spectroscopy (NIRS)-monitored patients, with (dashed line) and without (solid line) mechanical ventilation. Patients who were mechanically ventilated had lower diastolic and mean blood pressures (BP) despite lower SaO2. (ns = not significant.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Cerebral and somatic near-infrared spectroscopy (NIRS) measurements and regional oxygen extraction ratios (OER) in NIRS-monitored patients. Mechanical ventilation resulted in differential effects on regional blood flow: cerebral oxygenation and flow was increased, and somatic oxygenation and flow was decreased, in patients managed with mechanical ventilation. (rSO2 = oxyhemoglobin saturation.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Distribution of patients at incremental levels of ventilation charges. More patients in the near-infrared spectroscopy (NIRS) group had zero charges for ventilation as compared with the control group. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2009 The Society of Thoracic Surgeons Terms and Conditions


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