Hyperoxia and Mortality in Neonates After Norwood Operation
Author Information
Author(s): Beshish Asaad G., Aljiffry Alaa, Xiang Yijin, Evans Sean, Scheel Amy, Harriott Ashley, Patel Shayli, Amedi Alan, Harding Amanda, Davis Joel, Shashidharan Subhadra, Kwiatkowski David M.
Primary Institution: Emory University School of Medicine, Children’s Healthcare of Atlanta
Hypothesis
Is hyperoxia while on extracorporeal life support associated with mortality in neonates following Norwood operation?
Conclusion
Neonates with hyperoxia during the first 48 hours of extracorporeal life support post-Norwood operation had higher odds of mortality in unadjusted analysis, but this association was not significant when adjusted for confounding variables.
Supporting Evidence
- Patients in the hyperoxia group had higher mortality rates (77% vs. 39%).
- Hyperoxia was associated with longer cardiopulmonary bypass times.
- Patients in the hyperoxia group had higher serum lactate levels within 2 hours of ECLS cannulation.
- Using ROC analysis, a PaO2 > 182 mmHg was determined to have optimal discriminatory ability for mortality.
Takeaway
Babies who get too much oxygen after heart surgery might be at risk, but we need more studies to be sure.
Methodology
This is a single-center retrospective cohort study evaluating neonates who underwent Norwood operation and required extracorporeal life support.
Potential Biases
There may be bias in which patients are exposed to hyperoxia due to the lack of a standard protocol.
Limitations
The study is limited by its retrospective design and the lack of a standardized protocol for oxygen levels.
Participant Demographics
{"age":"6 days (median)","weight":"3.2 kg (median)","sex_distribution":{"male":40,"female":25},"race_distribution":{"caucasian":31,"african_american":29,"hispanic":3,"other":2}}
Statistical Information
P-Value
p=0.003
Confidence Interval
95% CI: 0.58–0.81
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website