Effect of Optimizing Regional Cerebral Oxygen Saturation during Infant Cardiac Surgery on the Incidence of Postoperative Delirium: A Retrospective Study.

Purpose: To investigate the effect of optimizing regional cerebral oxygen saturation (rScO₂) on the incidence of postoperative delirium and surgical outcome in infants with congenital heart disease.

Methods: Sixty-one infants experienced desaturation in rScO₂ of 10% from baseline for more than 30 seconds during surgery between January 2020 and January 2022. Among them, 32 cases (Group A) received the corresponding treatment in the process of desaturation and 29 cases (Group B) were observed without receiving any treatment. General information, cerebral oxygen saturation, the incidence of postoperative delirium, and other relevant clinical data were collected.

Results: The duration and severity of intraoperative rScO₂ desaturation in Group A were significantly lower than those in Group B. The incidence of postoperative delirium in Group A was significantly lower than that in Group B. There was no significant difference in the positive screening score for delirium between the two groups. Binary logistic regression analysis showed that the aortic cross-clamp time, mechanical ventilation duration, and severity of intraoperative rScO₂ desaturation were significantly correlated with the occurrence of postoperative delirium.

Conclusion: Aggressive rScO₂ desaturation treatment is associated with a lower incidence of postoperative delirium and improved surgical outcomes.