Children's Hospital of Wisconsin

David Hehir, MD, Primary Investigator
Herma Heart Center
Milwaukee, WI
Research project: Correlation of Cerebral Near-Infrared Spectroscopy with Serum Biomarkers of Brain Injury in Infants after Cardiac Surgery
Funding requested: Year 1 - $20,000
Funding requested: Year 2 - $9,714

For many children with complex congenital heart disease, open-heart surgery utilizing cardiopulmonary bypass is life-saving. However, for some children, this strategy contributes to serious neurologic events and poor long-term neuro-developmental outcome. Although rare, these complications can have significant negative impact on functioning within society and on quality of life. As a research team, we continue to investigate techniques and management strategies both in the operating room and the intensive care unit to improve not only survival, but good neurological and developmental outcomes as well.

Our study proposal, Correlation of Cerebral Near-Infrared Spectroscopy with Serum Biomarkers of Brain Injury in Infants after Cardiac Surgery, will investigate the relationship of lower oxygen levels in the brain to blood markers of brain injury during surgery and in the post-operative period. Our research team has extensive experience using non-invasive monitoring of tissue oxygen levels of the brain to guide treatments during surgery and in the intensive care unit. Limited studies have correlated a specific threshold in brain oxygenation as detected by noninvasive monitoring and irreversible damage to brain cells. Our study combines real-time monitoring of brain oxygen levels using cerebral Near Infrared Spectroscopy (NIRS) with blood tests indicating brain cell damage (serum levels of S100B and neuron-specific enolase). The study will enroll approximately 70 patients between one and 12 months of age.

Blood samples will be taken for assay of serum levels of S100B and neuron-specific enolase during surgery and at regular intervals during the first 48 hours in the intensive care unit. NIRS will be used to monitor brain oxygenation throughout this time period. In addition, standardized monitoring data and therapeutic interventions will be recorded.

The goal if this study will be to increase our knowledge of the mechanisms of brain injury occurring during and after open-heart surgery with cardiopulmonary bypass. The relationship between brain oxygenation as detected with NIRS and markers for brain injury will aid in designing treatment strategies to limit brain injury in patients with congenital heart disease.