• Maria A Vélez-Esquivia, Santiago Pedroza, Richard Rivera, Juan Camayo-Zorrilla, and Gustavo A Cruz-Suárez.
• Departamento de Anestesiología, Universidad Icesi, Cali, Colombia.
• J. Cardiothorac. Vasc. Anesth. 2024 Mar 2.

ObjectiveThis study aimed to delineate the recovery patterns of regional oxygen saturation (SrO2) in pediatric cardiac surgery patients subjected to remote ischemic preconditioning (RIPC), utilizing near-infrared spectroscopy (NIRS) for quantification. It also sought to establish the correlation between these perfusion patterns and postoperative clinical outcomes.DesignA prospective longitudinal observational study.SettingThe study was conducted at (BLINDED FOR REVIEW), a high-complexity service provider institution in (BLINDED FOR REVIEW).ParticipantsPediatric patients (younger than 18 years of age) scheduled for elective cardiac surgery requiring cardiopulmonary bypass between August 2022 and July 2023.InterventionsRIPC was performed after anesthetic induction, involving cycles of ischemia and reperfusion on a lower limb. Monitoring included SrO2 using NIRS.Measurements And Main ResultsThe study identified 4 distinct patterns of SrO2 during RIPC. Findings demonstrated a significant association between the negative SrO2 pattern and increased postoperative adverse events, including extended hospital stays and higher mortality, while a positive pattern was associated with better outcomes.ConclusionsSpecific patterns of SrO2 response to RIPC may serve as important indicators for risk stratification in congenital heart surgery. This study illustrated the potential of NIRS in detecting hypoxic states and predicting postoperative outcomes, emphasizing the need for standardized clinical interpretation of RIPC patterns.Copyright © 2024 Elsevier Inc. All rights reserved.

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