{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:03:45Z","timestamp":1785301425345,"version":"3.55.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Neurological injury remains an important concern in paediatric patients after congenital heart disease (CHD) surgery with cardiopulmonary bypass (CPB). Regional cerebral oxygen saturation (rScO\n                      <jats:sub>2<\/jats:sub>\n                      ) can be used to identify unstable intraoperative cerebral oxygenation, but its association with the postoperative responses of brain injury biomarkers remains unclear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-centre observational cohort study included 104 children who underwent congenital heart surgery with CPB. The maximum intraoperative decrease in rScO\n                      <jats:sub>2<\/jats:sub>\n                      was calculated as the preoperative value minus the lowest value recorded during bypass, during aortic cross-clamping, or after the return of spontaneous circulation. Severe cerebral desaturation was defined as a decrease of at least 20%. The levels of inflammatory cytokines and biomarkers of brain injury were measured preoperatively and on postoperative Days 0 (POD0), POD1, and POD2. Postoperative changes were calculated as log\n                      <jats:sub>2<\/jats:sub>\n                      fold changes from baseline and z-standardized. The composite inflammation score derived from tumour necrosis factor-alpha (TNF-\u03b1), interleukin-1 beta (IL-1\u03b2), interleukin-6 (IL-6), and interleukin-8 (IL-8) levels, and the composite brain injury score derived from glial fibrillary acidic protein (GFAP), S100 calcium-binding protein B (S100B), and neuron-specific enolase (NSE) levels were averaged to derive the composite brain injury score. Adjusted associations were evaluated using multivariable linear regression models, linear mixed-effects models (LMMs), and generalized estimating equations (GEEs), with the non-severe group serving as the reference category.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Children in the severe group were younger than those in the non-severe group, but most of the perioperative characteristics were similar. Severe desaturation was not associated with the composite inflammation score. In contrast, severe desaturation was independently associated with a higher postoperative composite brain injury score in both the LMM and the GEEs. The strongest difference between the severe and non-severe groups occurred on POD1 and remained significant after false discovery rate correction. Single-marker analyses showed directionally positive postoperative responses for GFAP, S100B, and NSE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      A maximum intraoperative decrease in rScO\n                      <jats:sub>2<\/jats:sub>\n                      of at least 20% was associated with postoperative responses of brain injury biomarkers in children who underwent congenital heart surgery with CPB. The association was most evident on POD1 and attenuated by POD2.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1879937","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:46:56Z","timestamp":1785300416000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Time-dependent responses of brain injury biomarkers after severe cerebral desaturation in paediatric patients during cardiac surgery with cardiopulmonary bypass: a single-centre observational cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Zeng-Chun","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital","place":["Fuzhou, China"]},{"name":"Department of Cardiac Surgery, Fujian Children\u2019s Hospital (Fujian Branch of Shanghai Children\u2019s Medical Center)","place":["Fuzhou, 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Children\u2019s Hospital (Fujian Branch of Shanghai Children\u2019s Medical Center)","place":["Fuzhou, China"]},{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Fujian Children\u2019s Hospital (Fujian Branch of Shanghai Children\u2019s Medical Center)","place":["Fuzhou, China"]},{"name":"College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute of Life Sciences, College of Biological Science and Engineering, Fuzhou University","place":["Fuzhou, 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