Cardiac surgery, in both children and adults, has progressed substantially over the past several decades. The focus has shifted from surviving surgery, to the post-operative quality of life of patients. Improving neurocognitive outcomes is now one of the central areas of investigation, with progress occurring across multiple fronts. However, neurocognitive deficits are still a common feature of cardiac surgery, and there are substantial gaps in our knowledge. One of the main issues is the continued inability to directly monitor the brain’s well-being during operative procedures. Indirect measures of cerebral well-being, including cerebral tissue haemoglobin saturation and processed EEG values are in clinical use, but have thus far failed to clearly improve clinical outcomes, though research and development continues.
Mitochondrial oxygenation is a final common pathway for all cellular metabolism that can be monitored using broadband near infrared spectroscopic techniques in the brain. The work proposed in the project will advance our understanding of cerebral-level ischaemia during cardiopulmonary bypass, and increase our understanding of the relationships between blood pressure, cerebral tissue haemoglobin oxygenation and mitochondrial oxygenation in cerebral tissue. Concretely, understanding mitochondrial oxygenation status and its relationship with blood pressure will allow individually tailored blood pressure management during cardiopulmonary bypass in children and adults.
This project aims to connect Australian Anaesthesia researchers in paediatrics and adults, across two states, and also to foster collaboration with an internationally world-class biomedical engineering group. It’s focus on common physiology that is crucial to safe anaesthesia and surgery further emphasizes it’s potential to advance the specialty in this region.
Dr Justin Skowno, The Children’s Hospital at Westmead
The project was awarded funding of $66,846 through the ANZCA research grants program for 2019.
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