{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:09:45Z","timestamp":1779185385436,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Advances in the treatment of pediatric congenital heart disease have increased survival rates. Despite efforts to prevent neurological injury, many patients suffer from impaired neurodevelopmental outcomes. Compromised cerebral autoregulation can increase the risk of brain injury following pediatric cardiac surgery with cardiopulmonary bypass. Monitoring autoregulation and maintaining adequate cerebral blood flow can help prevent neurological injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Our objective was to evaluate autoregulation parameters and to define the optimal blood pressure as well as the lower and upper blood pressure limits of autoregulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Autoregulation was monitored prospectively in 36 infants after cardiopulmonary bypass surgery for congenital heart defects between January and December 2019. Autoregulation indices were calculated by correlating invasive arterial blood pressure, cortical oxygen saturation, and relative tissue hemoglobin levels with near\u2010infrared spectroscopy parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean patient age was 4.1\u2009\u00b1\u20092.8\u00a0months, and the mean patient weight was 5.2\u2009\u00b1\u20091.8\u00a0kg. Optimal mean arterial pressure could be identified in 88.9% of patients via the hemoglobin volume index and in 91.7% of patients via the cerebral oxygenation index, and a lower limit of autoregulation could be found in 66.7% and 63.9% of patients, respectively. No significant changes in autoregulation indices at the beginning or end of the monitoring period were observed. In 76.5%\u2009\u00b1\u200911.1% and 83.8%\u2009\u00b1\u20099.9% of the 8 and 16\u2009h monitoring times, respectively, the mean blood pressure was inside the range of intact autoregulation (below in 21.5%\u2009\u00b1\u200925.4% and 11.3%\u2009\u00b1\u200916.5% and above in 8.7%\u2009\u00b1\u200910.4% and 6.0%\u2009\u00b1\u200911.0%, respectively). The mean optimal blood pressure was 57.4\u2009\u00b1\u20098.7\u2009mmHg and 58.2\u2009\u00b1\u20097.9\u2009mmHg and the mean lower limit of autoregulation was 48.8\u2009\u00b1\u20098.3\u2009mmHg and 45.5\u2009\u00b1\u20096.7\u2009mmHg when generated via the hemoglobin volume index and cerebral oxygenation index, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Postoperative noninvasive autoregulation monitoring after cardiac surgery in children can be reliably and safely performed using the hemoglobin volume index and cerebral oxygenation index and provides robust data. This monitoring can be used to identify individual hemodynamic targets to optimize autoregulation, which differs from those recommended in the literature. Further evaluation of this subject is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14555","type":"journal-article","created":{"date-parts":[[2022,9,9]],"date-time":"2022-09-09T20:37:34Z","timestamp":1662755854000},"page":"1320-1329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Identifying the optimal blood pressure for cerebral autoregulation in infants after cardiac surgery by monitoring cerebrovascular reactivity\u2014A pilot study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4725-713X","authenticated-orcid":false,"given":"Julian","family":"Zipfel","sequence":"first","affiliation":[{"name":"Section of Paediatric Neurosurgery, Department of Neurosurgery University of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berit","family":"Wikidal","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit University Children's Hospital of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadett","family":"Schwaneberg","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit University Children's Hospital of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin U.","family":"Schuhmann","sequence":"additional","affiliation":[{"name":"Section of Paediatric Neurosurgery, Department of Neurosurgery University of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry","family":"Magunia","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine, University Hospital T\u00fcbingen Eberhard\u2010Karls\u2010University Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Hofbeck","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit University Children's Hospital of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Schlensak","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery University of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Schmid","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit University Children's Hospital of Tuebingen  Tuebingen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Neunhoeffer","sequence":"additional","affiliation":[{"name":"Paediatric Intensive Care Unit University Children's Hospital of Tuebingen  Tuebingen 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