Predictive value of cerebral oxygenation with near infrared spectroscopy for in-hospital mortality in pediatric congenital heart disease surgery: a retrospective observational study

Congenital heart disease still has significant morbidity and mortality despite advances in surgery. Inadequate tissue perfusion is thought to be the primary cause. Monitoring children with cerebral oxygenation with near infrared spectroscopy before and after surgery may predict pre- and post-operative mortality. This study evaluated the benefits of this method in terms of mortality. This study is a retrospective, observational, single-center study. A total of 166 patients who underwent congenital heart surgery were included in the study. In-hospital mortality was analyzed in two groups: those who developed complications and those who did not. Cerebral oxygenation with near infrared spectroscopy results were recorded before surgery, during surgery (before and after aortic clamping), and after surgery. The study continued with 166 patients. Twenty-five patients died. Significant differences were observed in cerebral oximetry values measured at different time points according to cross-clamp time. Oximetry values before (70.0 [46.0–92.0] 61.0 [53.0–88.0] p = 0.003) and after (58.0 [43.0–95.0] 51.0 [46.0–76.0] p = 0.009) aortic cross-clamping were significantly lower in the non-surviving children than in the surviving children. In the multivariate analysis performed for independent risk factor assessment, surgery duration, pre-cross-clamp SctO2 (%), and lowest SctO2 (%) were found to be significant. Assessing tissue perfusion before and after surgery may be beneficial in congenital heart disease surgery by enabling the early detection of clinical deterioration.