Effects of hyperoxia in pediatric perfusion patients: a scoping review

Area of Science:

• Pediatric Cardiology
• Critical Care Medicine
• Biomedical Engineering

Background:

• Hyperoxia, or excessive oxygen levels, in pediatric patients undergoing cardiopulmonary bypass (CPB) is associated with adverse outcomes.
• These adverse effects include reoxygenation injury, increased mortality, heightened inflammatory response, and cerebral injury.
• Existing research shows a correlation between hyperoxia and negative outcomes, but definitions of hyperoxia lack consistency.

Purpose of the Study:

• To conduct a scoping review synthesizing existing literature on the adverse effects of hyperoxia in pediatric CPB patients.
• To categorize these adverse effects based on patient age, presence of cyanosis, and partial pressure of oxygen (PaO2) levels.
• To identify the need for standardized oxygenation management and a consistent definition of hyperoxia in this population.

Main Methods:

• A comprehensive literature search was performed across major databases: PubMed, CINAHL, Embase, and Web of Science.
• The review synthesized findings related to hyperoxia and its adverse effects in pediatric CPB patients.
• Data were categorized based on age, cyanotic status, and PaO2 thresholds.

Main Results:

• The review identified varied definitions and thresholds for hyperoxia across studies.
• Adverse effects of hyperoxia were observed and categorized based on patient demographics and oxygen levels.
• Significant heterogeneity in oxygen management protocols was noted in pediatric CPB procedures.

Conclusions:

• There is a critical need for standardized oxygenation management protocols in pediatric cardiopulmonary bypass.
• A consistent definition of hyperoxia, differentiating between cyanotic and acyanotic patients, is essential for accurate research and clinical practice.
• Implementing standardized protocols can mitigate adverse effects and improve outcomes for pediatric cardiac surgery patients.