What question did this study set out to answer?

To determine whether resting muscle oxygen saturation and oxygen consumption rates differ between healthy children and those with cyanotic or acyanotic congenital heart disease.

May 24, 2019Pediatric Anesthesia

Assessment of muscle oxygenation in children with congenital heart disease

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Why the study?

Adaptive responses to congenital heart disease alter muscle perfusion and metabolism, but whether resting muscle oxygen saturation is lower or muscle oxygen consumption differs in children with acyanotic versus cyanotic congenital heart disease and healthy controls remained unclear.

Is resting muscle oxygen saturation lower in children with acyanotic or cyanotic congenital heart disease compared to healthy children?

Comparison

Acyanotic congenital heart disease vs cyanotic congenital heart disease vs healthy controls

Design

Physiological observational study

Authors

FRFaith J. RossSeattle Children's Hospital LALorilee S. L. ArakakiUniversity of Washington WCWayne A. CiesielskiUniversity of Washington

Discussion

Member takes

Implication

Noninvasive MOx monitoring may detect altered perfusion in pediatric CHD; leaves open need for validation before any clinical adoption.

Key Points

To determine whether resting muscle oxygen saturation and oxygen consumption rates differ between healthy children and those with cyanotic or acyanotic congenital heart disease.
Optical spectra were recorded from the calf or forearm in 49 pediatric participants (17 acyanotic congenital heart disease, 18 cyanotic congenital heart disease, and 14 controls), with 20 additional controls evaluated to construct the analytic model.
A custom fiber optic spectrometer evaluated muscle oxygen saturation (MOx) at baseline, during arterial occlusion, and during reperfusion, alongside desaturation rates during occlusion.
Two-sample t-tests were used to compare physiological metrics between each congenital heart disease group and controls.
Baseline MOx was lower in acyanotic (91.3%, 95% CI 85.9% to 96.7%) and cyanotic patients (91.1%, 95% CI 86.3% to 95.9%) compared to controls (98.9%, 95% CI 96.7% to 101.1%).
Reperfusion MOx remained reduced in acyanotic (84.6%, 95% CI 74.1% to 95.1%) and cyanotic cohorts (82.1%, 95% CI 74.5% to 89.7%) relative to controls (98.9%, 95% CI 96.5% to 101.3%).
The rate of muscle desaturation during arterial occlusion was significantly faster in cyanotic patients than in controls (0.46%/s, 95% CI 0.30% to 0.62%/s vs 0.17%/s, 95% CI 0.13% to 0.21%/s).

Structured PICO

Is resting muscle oxygen saturation lower in children with acyanotic or cyanotic congenital heart disease compared to healthy children?

Population

69 children (17 with acyanotic congenital heart disease, 18 with cyanotic congenital heart disease, 14 controls, and 20 additional controls used to develop the analytic model)

Intervention

Noninvasive spectroscopic monitoring of muscle oxygenation (MOx) using a custom fiber optic spectrometer system

Comparator

Healthy control children

Outcome

Resting muscle oxygen saturation (MOx) at baseline, during arterial occlusion, and during reperfusion, and rate of muscle desaturationsurrogate

Children with both cyanotic and acyanotic congenital heart disease have abnormal muscle oxygenation, suggesting noninvasive spectroscopic monitoring could help identify hemodynamic compromise.

Cite This Study

Ross et al. (2019) studied this question.

synapsesocial.com/papers/6a9068aa6bfd95d7bd4de1f7 https://doi.org/10.1111/pan.13668

Topics

Congenital heart disease adults

View Full Paper

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Assessment of muscle oxygenation in children with congenital heart disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Assessment of muscle oxygenation in children with congenital heart disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider