Abstract 14578: Hyperoxia During Cardiopulmonary Bypass is Associated With Mortality in Infants Undergoing Cardiac Surgery

Introduction:Patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) may have elevated blood oxygen tension during surgery. In other settings, hyperoxia (HO) has been associated with adverse outcomes in critical illness. Data are not available regarding the association of HO and outcomes in infants undergoing CPBHypothesis:Among infants undergoing cardiac surgery, HO during CPB is associated with an increased risk of morbidity and mortality.Methods:This was a retrospective single-center study at an academic tertiary children?s hospital. All infants (<1 year) undergoing CPB between 1/ 2015 - 12/2017 were included. Medical records were reviewed for patient characteristics, operative variables (including average partial arterial pressure of oxygen (PaO2)) and outcomes. The PaO2 with maximal sensitivity (75%) and specificity (50%) for operative mortality was identified using receiver operating characteristic curves. Univariate and multivariable logistic regression analysis were performed using appropriate statistics.Results:The study included 471 infants with a median age of 97 (15, 179) days, weight 4.85 (3.4, 6.36) kg, and CPB time 129 (91, 185) min. A PaO2 of 313mmHg on CPB had optimal discriminatory ability for operative mortality. Infants with PaO2 >313mmHg were more likely to have AKI, postoperative length of stay (PLOS) and mortality (Table). They were younger, weighed less, had longer CPB times, and higher STAT surgical severity scores. There was no difference in sex, race, preoperative creatinine, single ventricle physiology, or presence of genetic syndrome. When co-variables were controlled, PaO2>313 was associated with an adjusted odds ratio for mortality of 3.31 (1.19, 9.25), but did not predict AKI or PLOS.Conclusion:Hyperoxia was an independent risk factor for mortality among infants undergoing cardiac surgery on CPB. Future prospective evaluation of HO is necessary to determine causation of poor outcomes.