Objective:

To investigate longitudinal patterns of regional cerebral oxygen saturation (CrSO2) after cardiopulmonary bypass (CPB) surgery in children with congenital heart disease (CHD) and their association with postoperative delirium (POD).

Approach:

Key Findings:

• The incidence of POD was 47.7% (31/65).
• Univariate analysis showed significantly lower CrSO2 levels at T1-T4 and minimum CrSO2 values in the POD group compared to the NPOD group (all P < 0.05).
• Multivariate logistic regression indicated that lower CrSO2 levels in the early postoperative period independently predicted POD (OR = 0.941, 95% CI: 0.894–0.991, P = 0.021).
• LMM analysis revealed significantly lower CrSO2 levels in the POD group at 6 h, 12 h, and 48 h postoperatively (Bonferroni-corrected P-values: 0.009, 0.030, and 0.018, respectively), although the overall CrSO2 trend over time was similar between groups.

Interpretation:

Early postoperative CrSO2 dynamics in pediatric CHD patients undergoing CPB are associated with POD, with lower CrSO2 levels observed in the POD group.

Limitations:

• The study was limited to a single center, which may affect generalizability.
• The sample size may not be sufficient to capture all variations in CrSO2 and POD.

Conclusion:

Continuous monitoring of CrSO2 could facilitate early detection and timely intervention for POD.

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