Multisite measurement of regional oxygen saturation in Fontan patients with and without protein-losing enteropathy at rest and during exercise

Schroeer S, Fahlbusch FB, Münch F, Alkassar M, Toka HR, Rauh M, Rueffer A, Cesnjevar R, Dittrich S, Toka O, Moosmann J (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Pediatric Research Nature Publishing Group: Open Access Hybrid Model Option A

DOI: 10.1038/s41390-019-0346-3

Abstract

Background: Protein-losing enteropathy (PLE) is a severe complication of Fontan circulation with increased risk of end-organ dysfunction. We evaluated tissue oxygenation via near-infrared spectroscopy (NIRS) at different exercise levels in Fontan patients. Methods: Assessment of multisite NIRS during cycle ergometer exercise and daily activities in three groups: Fontan patients with PLE; without PLE; patients with dextro-transposition of the great arteries (d-TGA); comparing univentricular with biventricular circulation and Fontan with/without PLE. Renal threshold analysis (<65%;<55%;<45%) of regional oxygen saturation (rSO2) was performed. Results: Fontan patients showed reduced rSO2 (p < 0.05) in their quadriceps femoris muscle compared with biventricular d-TGA patients at all time points. rSO2 in renal tissue was reduced at baseline (p = 0.002), exercise (p = 0.0062), and daily activities (p = 0.03) in Fontan patients with PLE. Renal threshold analysis identified critically low renal rSO2 (rSO2 < 65%) in Fontan patients with PLE during exercise (95% of monitoring time below threshold) and daily activities (83.7% time below threshold). Conclusion: Fontan circulation is associated with decreased rSO2 values in skeletal muscle and hypoxemia of renal tissue solely in patients with PLE. Reduced rSO2 already during activities of daily life, might contribute to comorbidities in patients with Fontan circulation, including PLE and renal failure.

Authors with CRIS profile

Manfred Rauh Department of Paediatrics and Adolescent Medicine Robert Cesnjevar Department of Paediatric Cardiac Surgery Sven Dittrich Department of Paediatric Cardiology Julia Moosmann Department of Paediatrics and Adolescent Medicine

Involved external institutions

Manatee Memorial Hospital US United States (USA) (US)

How to cite

APA:

Schroeer, S., Fahlbusch, F.B., Münch, F., Alkassar, M., Toka, H.R., Rauh, M.,... Moosmann, J. (2019). Multisite measurement of regional oxygen saturation in Fontan patients with and without protein-losing enteropathy at rest and during exercise. Pediatric Research. https://doi.org/10.1038/s41390-019-0346-3

MLA:

Schroeer, Simon, et al. "Multisite measurement of regional oxygen saturation in Fontan patients with and without protein-losing enteropathy at rest and during exercise." Pediatric Research (2019).

BibTeX: Download