Elevated arterial blood pressure after superior cavo-pulmonary anastomosis is associated with elevated pulmonary artery pressure and cerebrovascular dysautoregulation

Background Elevated arterial blood pressure (ABP) is common after superior bidirectional cavopulmonary anastomosis (BCPA). The effects of elevated ABP after BCPA on cerebrovascular hemodynamics are unknown. We sought to determine the relationship between elevated ABP and cerebrovascular autoregulati...

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Bibliographic Details
Published in:Pediatric research 2018-09, Vol.84 (3), p.356-361
Main Authors: Cabrera, Antonio G, Kibler, Kathleen K, Blaine Easley, R, Goldsworthy, Michelle, Shekerdemian, Lara S, Andropoulos, Dean B, Heinle, Jeffrey, Gottlieb, Erin A, Vu, Eric, Brady, Ken M
Format: Article
Language:English
Subjects:
Blood pressure
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Pulmonary arteries
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Summary:Background Elevated arterial blood pressure (ABP) is common after superior bidirectional cavopulmonary anastomosis (BCPA). The effects of elevated ABP after BCPA on cerebrovascular hemodynamics are unknown. We sought to determine the relationship between elevated ABP and cerebrovascular autoregulation after BCPA. Methods Prospective, observational study on infants with single-ventricle physiology after BCPA surgery. Continuous recordings of mean ABP, mean cavopulmonary artery pressure (PAP), near-infrared spectroscopy measures of cerebral oximetry (regional cerebral oxygen saturation (rSO 2 )), and relative cerebral blood volume index were obtained from admission to extubation. Autoregulation was measured as hemoglobin volume index (HVx). Physiologic variables, including the HVx, were tested for variance across ABP. Results Sixteen subjects were included in the study. Elevated ABP post-BCPA was associated with both, elevated PAP ( P
ISSN:0031-3998
1530-0447
DOI:10.1038/pr.2018.31