Table 2
Patient demographics and clinical characteristics for neonates requiring extracorporeal life support post-Norwood operation stratified by PaO2 levels into hyperoxia group (PaO2 > 182 mmHg) and non-hyperoxia Group (PaO2 ≤ 182 mmHg).
| Variables | Non-hyperoxia group | Hyperoxia group | p-value |
|---|---|---|---|
| Average PaO2 £ 182 | Average PaO2 > 182 | ||
| (n = 31) | (n = 34) | ||
| Age (days) | 6.0 [4.0, 7.5] | 6.0 (4.3, 7.0) | 0.984 |
| Weight (Kg) | 3.1 [2.6, 3.5] | 3.3 (2.8, 3.6) | 0.641 |
| Sex | |||
| Male | 16 (52%) | 24 (71%) | 0.188 |
| Female | 15 (48%) | 10 (29%) | |
| Race | 0.967 | ||
| Caucasian | 15 (48%) | 16 (47%) | |
| African American | 14 (45%) | 15 (44%) | |
| Hispanic | 1 (3%) | 2 (6%) | |
| Other | 1 (3%) | 1 (3%) | |
| Gestational Age (weeks) | 38.0 [37.0, 39.0] | 38.5 (37.0, 39.0) | 0.323 |
| Chromosomal Abnormality and Genetic Syndrome | 9 (29%) | 5 (15%) | 1 |
| Primary Cardiac Diagnosis | 0.226 | ||
| AA & critical AS | 2 (7%) | 1 (3%) | |
| DILV | 3 (10%) | 1 (3%) | |
| DORV | 1 (3%) | 0 (0%) | |
| HLHS | 22 (71%) | 28 (82%) | |
| Single Ventricle Other | 0 (0%) | 3 (9%) | |
| Tricuspid Atresia | 3 (10%) | 1 (3%) | |
| HLHS Variant | 0.2 | ||
| MA/AA | 11 (50%) | 15 (52%) | |
| MA/AS | 1 (5%) | 2 (7%) | |
| MS/AA | 4 (18%) | 10 (35%) | |
| MS/AS | 6 (27%) | 2 (7%) | |
| Pre-Norwood Respiratory Support | 0.327 | ||
| RA | 8 (26%) | 10 (29%) | |
| NC | 4 (13%) | 10 (29%) | |
| HFNC | 6 (19%) | 4 (12%) | |
| Intubated | 13 (42%) | 10 (29%) | |
| Pre-Norwood PGE1 Dose (mcg/kg/min) | 0.02 [0.01, 0.02] | 0.02 (0.01, 0.03) | 0.39 |
| Preoperative VIS score | 0.0 [0.0, 4.3] | 1.5 (0.0, 7.8) | 0.155 |
| Pre-Norwood Transthoracic Echocardiogram | |||
| Atrioventricular Valve Regurgitation (AVVR) | 0.226 | ||
| Moderate – Severe | 28 (90%) | 25 (76%) | |
| No – Trivial – Mild AVVR | 3 (10%) | 8 (24%) | |
| Systemic Ventricular Function | 0.713 | ||
| Normal | 17 (55%) | 18 (55%) | |
| Mild Dysfunction | 2 (7%) | 4 (12%) | |
| Moderate – Severe Dysfunction | 12 (39%) | 11 (33%) | |
| Pre-Norwood Ascending Aorta Diameter (mm) | |||
| Diameter (mm) | 3.30 [1.90, 4.80] | 2.30 (1.90, 3.70) | 0.148 |
| Median z-score | −3.10 [− 4.44, −2.55] | −4.18 (−4.57, −3.30) | 0.16 |
| Pre-Norwood ascending aorta groups based on diameter | 0.346 | ||
| ≤1.5 mm | 1 (3%) | 2 (6%) | |
| 1.6–1.9 mm | 8 (26%) | 8 (24%) | |
| 2.0–3.9 mm | 9 (29%) | 16 (47%) | |
| ≥4.0 mm | 13 (42%) | 8 (24%) | |
| Source of pulmonary blood flow | <0.001 | ||
| m-BTT shunt | 22 (71%) | 6 (18%) | |
| Sano Shunt | 9 (29%) | 28 (82%) | |
| Type of systemic ventricle | 0.235 | ||
| LV | 8 (26%) | 4 (12%) | |
| RV | 23 (74%) | 29 (85%) | |
| Undetermined | 0 (0%) | 1 (3%) | |
| Intraoperative transesophageal echocardiogram | |||
| Atrioventricular Valve Regurgitation (AVVR) | 0.881 | ||
| Moderate – severe | 20 (77%) | 20 (71%) | |
| No – trivial – mild AVVR | 6 (23%) | 8 (29%) | |
| Systemic ventricular function | 0.359 | ||
| Normal | 18 (69%) | 17 (61%) | |
| Mild dysfunction | 6 (23%) | 5 (18%) | |
| Moderate – severe dysfunction | 2 (8%) | 6 (21%) | |
| Cardiopulmonary bypass time (min) | 165.0 [152.0, 185.0] | 187.0 (171.5, 228.3) | 0.023 |
| Cross clamp time (min) | 70.0 [58.5, 83.0] | 68.0 (57.0, 85.0) | 0.952 |
| Circulatory arrest time (min) | 7.0 [2.0, 34.5] | 4.0 (2.0, 23.5) | 0.73 |
| Post-Norwood iNO on arrival to CICU | 8 (26%) | 9 (27%) | 1 |
| Post-Norwood VIS-score | |||
| First 24 h | 20.0 [12.5, 27.0] | 25.0 (20.0, 30.0) | 0.027 |
| Hours 24–48 | 23.0 [15.0, 32.5] | 30.0 (21.3, 41.5) | 0.017 |
| Delayed sternal closure | 23 (74%) | 31 (91%) | 0.136 |
| Post-Norwood cath intervention | 23 (74%) | 23 (68%) | 0.759 |
| Median PaO2 (mmHg) | 91.6 [67.7, 140.8] | 289.0 [264.9, 337.2] | <0.0001 |
| PaO2 range (mmHg) | 62.4 – 175.8 | 182.4 – 412.3 | <0.0001 |
| Number of PaO2 samples per patient | 22.0 [18.0, 27.0] | 22.5 [19.0, 26.0] | 0.385 |
| Cannulation site | 0.003 | ||
| Peripheral | 16 (53%) | 5 (15%) | |
| Central | 14 (47%) | 29 (85%) | |
| ECLS indication | 0.488 | ||
| E-CPR | 11 (36%) | 16 (47%) | |
| Cardiac | 20 (65%) | 18 (53%) | |
| Time from CICU arrival to ECLS cannulation (h) | 132.6 [42.9, 305.7] | 13.3 [4.0, 74.7] | 0.003 |
| Arterial blood gas within 2 h from ECLS initiation | |||
| Lowest pH | 7.3 [7.2, 7.3] | 7.3 [7.2, 7.4] | 0.16 |
| Highest serum lactic acid | 5.8 [3.4, 14.5] | 14.6 [10.0, 19.7] | 0.01 |
| Worst arterial blood gas within 24 h from ECLS initiation | |||
| Lowest pH | 7.4 [7.4, 7.5] | 7.5 [7.4, 7.5] | <0.001 |
| Highest serum lactic acid | 1.8 [1.0, 3.4] | 2.0 [1.6, 14.3] | 0.076 |
| Initial ECLS Flow (first 4 h) (mL/kg/min) | 124.1 [101.9, 147.7] | 152.7 [123.5, 180.1] | 0.006 |
| Duration of ECLS (h) | 82.0 [52.5, 151.0] | 138.5 (104.3, 205.3) | 0.005 |
| ECLS complications | |||
| Cardiovascular | 24 (77%) | 32 (97%) | 0.047 |
| Renal | 15 (48%) | 21 (62%) | 0.404 |
| Hematologic | 11 (36%) | 18 (53%) | 0.244 |
| Mechanical | 11 (36%) | 6 (18%) | 0.176 |
| Neurologic | 6 (20%) | 8 (24%) | 0.97 |
| Pulmonary | 4 (13%) | 4 (12%) | 1 |
| Metabolic | 1 (3%) | 3 (9%) | 0.651 |
| Duration of mechanical ventilation (h) | 437.6 [181.6, 683.3] | 412.9 (276.7, 553.4) | 0.864 |
| Stage II or III AKI based on KDIGO score | 17 (54.8%) | 18 (52.9%) | 1 |
| Length of Stay (LOS) (days) | |||
| CICU LOS | 32.0 [19.0, 44.0] | 17.5 (10.3, 41.0) | 0.03 |
| Postoperative LOS | 40.0 [28.0, 95.5] | 17.5 (10.3, 43.3) | <0.001 |
| Hospital LOS | 49.0 [37.0, 76.5] | 24.5 (15.3, 49.8) | 0.001 |
| Operative mortality based on source of pulmonary blood flow | 0.005 | ||
| m-BTT shunt | 5/22 (22.7%) | 5/6 (83.3%) | |
| Sano shunt | 7/9 (77.8%) | 21/28 (75.0%)) | |
| Overall operative mortality | 12 (38.7%) | 26 (76.5%) | 0.005 |
Results depicted in n (%), median (interquartile range). Statistically significant values are indicated in bold.
Abbreviations: AA: Aortic Atresia; AS: Aortic Stenosis; DILV: Double Inlet left Ventricle; DORV: Double Outlet Right Ventricle; HLHS: Hypoplastic Left Heart Syndrome; MA/AA: Mitral Atresia/Aortic Atresia; MA/AS: Mitral Atresia/Aortic Stenosis; MS/AA: Mitral Stenosis/Aortic Atresia; MS/AS: Mitral Stenosis/Aortic Stenosis; PGE1: Prostaglandin; TTE: Transthoracic Echocardiogram; m-BTT shunt: modified Blalock Taussig Thomas shunt; LV: Left Ventricle; RV: Right Ventricle; TEE: Transesophageal Echocardiogram; VIS: Vasoactive Inotropic Score; CICU: Cardiac Intensive Care Unit.
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