Fan Yichen, Pan Qianling, Su Henghua, Pu Zhongchan, Zhu Linjie, Qi Bo, Su Diansan, Yang Liqun, Huang Dan, Yu Weifeng
Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Operation Room, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Front Pediatr. 2025 Jan 7;12:1416020. doi: 10.3389/fped.2024.1416020. eCollection 2024.
To discover the potential association between diminished intraoperative average SctO levels and postoperative neurodevelopmental delays among patients after pediatric living-donor liver transplantation.
Patients undergoing living-donor liver transplantation were recruited for this trial. The neurodevelopment status of patients was assessed using the Ages Stages Questionnaires. The primary outcome was the occurrence of neurodevelopmental delay among patients at different intervals following pediatric liver transplantation. Secondary outcomes included the duration of mechanical ventilation, rates of re-intubation, length of ICU stay, postoperative hospitalization, and intraoperative comparisons of mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO), arterial partial pressure of carbon dioxide (PaCO), and hemoglobin (Hb) concentration.
A total of 119 patients were included in the statistical analysis and assigned to high saturation group (HS) and low saturation group (LS) according to the average intraoperative cerebral tissue oxygen saturation values. Following adjustment for PELD scores, significant differences between the two groups were observed for the incidence of neurodevelopmental delay in communication at 1 and 3 months follow-up ( = 0.019 and = 0.020, respectively), fine motor at six months follow-up ( = 0.014), and problem-solving abilities at one year follow-up ( = 0.047). Moverover, the length of ICU stay ( = 0.009) and postoperative hospitalization ( = 0.029) in LS group were also significant prolonged.
This prospective observational study revealed that the patients with low average SctO values were more predisposed to experiencing postoperative neurodevelopment delays, suggesting a potential association between decreased average SctO and neurodevelopmental delay.
探讨小儿活体肝移植患者术中平均脑氧饱和度（SctO）降低与术后神经发育延迟之间的潜在关联。
招募接受活体肝移植的患者参与本试验。使用年龄与发育进程问卷评估患者的神经发育状况。主要结局是小儿肝移植后不同时间段患者神经发育延迟的发生情况。次要结局包括机械通气时间、再次插管率、重症监护病房（ICU）住院时间、术后住院时间，以及术中平均动脉压（MAP）、动脉血氧分压（PaO）、动脉血二氧化碳分压（PaCO）和血红蛋白（Hb）浓度的比较。
共有119例患者纳入统计分析，并根据术中平均脑组织氧饱和度值分为高饱和度组（HS）和低饱和度组（LS）。经小儿终末期肝病（PELD）评分校正后，两组在术后1个月和3个月随访时沟通方面神经发育延迟的发生率（分别为=0.019和=0.020）、术后6个月精细运动方面（=0.014）以及术后1年解决问题能力方面（=0.047）存在显著差异。此外，LS组的ICU住院时间（=0.009）和术后住院时间（=0.029）也显著延长。
这项前瞻性观察性研究表明，平均SctO值较低的患者术后更易出现神经发育延迟，提示平均SctO降低与神经发育延迟之间可能存在关联。
