The monitoring of cerebral tissue oxygen saturation by near-infrared spectroscopy (S_cerebO₂) is used widely in pediatric cardiac anesthesia. However, little information is available on the effects of changes in perioperative S_cerebO₂ on brain morphology and neurologic outcome. The primary hypothesis tested in this study was that intraoperative S_cerebO₂ during the comprehensive stage II procedure correlated with brain volumes assessed by magnetic resonance imaging and neurodevelopmental scores.

Retrospective observational cohort study.

University Hospital, Pediatric Heart Centre.

In 19 infants, the intraoperative course of S_cerebO₂ during the comprehensive stage II procedure was examined. Minimal S_cerebO₂ and integrated S_cerebO₂ below 45% (AUC) during surgery, as well as cerebral magnetic resonance imaging (MRI) examinations and Bayley III test at the ages of two-to-three years, were analyzed.

A positive correlation between minimal S_cerebO₂ and intracranial volume (p = 0.0243), total brain volume (p = 0.0243), and white matter volume (p = 0.0276) was observed, as was a negative correlation between AUC and intracranial volume (p = 0.0454) and white matter volume (p = 0.0381), respectively. No association was found between S_cerebO₂ and Bayley-III Score.

The correlation between S_cerebO₂ and brain volumes measured by MRI pointed out a possible importance of neuroprotective strategies aimed at optimizing S_cerebO₂ during complex congenital heart surgery. That no correlation between S_cerebO₂ and Bayley III Score was found suggested multifactorial causes for neurologic outcome in children with congenital heart defects.