近红外光谱监测局部组织氧饱和度评估臂丛神经阻滞的效果

目的 使用近红外光谱(NIRS)监测局部组织氧饱和度(StO₂),观察臂丛神经阻滞对前臂局部组织灌注的影响,并探讨StO₂评估臂丛神经阻滞效果的有效性。方法 选择行择期骨科前臂手术患者43例,男24例,女19例,年龄18～64岁,BMI 20～28 kg/m²,ASAⅠ或Ⅱ级。超声引导下行锁骨上臂丛神经阻滞,注射0.375%罗哌卡因20 ml。根据阻滞后20 min是否成功分为两组：阻滞成功组(Y组)和阻滞失败组(N组)。记录阻滞即刻、阻滞后5、10、15、20 min时HR、MAP和SpO₂,阻滞侧和非阻滞侧StO₂,计算上述时点阻滞侧与非阻滞侧StO₂的差值(ΔStO₂),绘制阻滞后5、10 min时ΔStO₂的受试者工作特征(ROC)曲线预测阻滞效果,并计算曲线下面积(AUC)和95%可信区间(CI)。结果 本研究最终阻滞成功38例(88.4%)。与非阻滞侧比较,阻滞后5、10、15、20 min Y组阻滞...     

儿童腹腔镜手术对局部脑氧饱和度的影响

目的评估儿童腹腔镜手术对局部脑氧饱和度是否有影响。方法选择年龄在5～10岁急性阑尾炎患儿40例,ASAⅠ～Ⅱ级。将患儿依据手术方式分为两组,腹腔镜组(L组)和开腹组(O组),每组各20例。两组患儿均采用气管内插管全身麻醉,舒芬太尼、丙泊酚和罗库溴铵快速诱导插管,术中泵注瑞芬太尼、丙泊酚维持麻醉,机械通气采用80%氧浓度。分别记录手术及麻醉时间,呼气末二氧化碳压力(P_(ET)CO_2),记录麻醉诱导后和开始手术前(T_0,基线),手术开始后15分钟(T_1),30分钟(T_2),45分钟(T_3),60分钟(T_4)和手术结束(T_5)的血流动力学参数,如心率(HR),平均动脉压(MAP),血氧饱和度(SpO_2)及左右局部脑氧饱和度(LrScO_2,RrScO_2)。结果L组患儿在手术开始后T_1、T_2、T_3时间段PETCO_2高于O组,与T_0比较,两组患儿在T_1时的LrScO_2(L组:77. 2±5. 5,O组:79. 2±5. 5)和RrScO_2(L组:80. 1±5. 1,O组:81. 6±3. 2),均逐渐下降,但均正常范围内,两组比较差异无统计学意义(P 0. 05)。结论儿童腹腔镜手术对局部脑氧饱和度无明显影响。     

脑氧饱和度监测下磷酸肌酸钠对腰椎手术患者术后早期恢复质量的影响

目的 探讨脑氧饱和度(rSO₂)监测下磷酸肌酸钠对腰椎手术患者术后早期恢复质量的影响。方法 选择2021年10月至2022年1月全麻下拟行腰椎体融合术的患者118例,男51例,女67例,年龄18～64岁,BMI<30 kg/m²,ASAⅡ或Ⅲ级。将患者随机分为两组：磷酸肌酸钠组(P组)和对照组(C组),每组59例。术中监测rSO₂并维持下降幅度不超过基线值的20%。手术开始后30 min内,P组静脉滴注磷酸肌酸钠1.0 g(溶于生理盐水100 ml);C组静脉滴注生理盐水100 ml。于术前1 d、术后1、3 d采用恢复质量量表(QoR-15)评估患者恢复质量。记录术中rSO₂降低次数及处理措施、术中麻醉药物用量、手术时间、麻醉时间、出血量、输液量、拔管时间、麻醉复苏室(PACU)停留时间、术后首次肛门排气时间、术后首次下床活动时间和术后住院时间。记录术后低血压、便秘、术后恶心呕吐(PONV)、谵妄和心律失常发生情况。结果 与术前1 d比较,术后1、3 d两组QoR-15评分明显降低(P<...     

赛肤润改善受压局部血氧饱和度的效果观察

目的探讨赛肤润用于预防压疮的效果。方法将60例诺顿评分<14分的骨科卧床患者分为对照组与观察组各30例,分别于局部使用凡士林和赛肤润预防压疮。评价患者的主观感受(骶尾部的疼痛感和舒适感),Ⅰ、Ⅱ期压疮的改善情况及受压局部经皮血氧饱和度(SpO2)的变化。结果观察组患者舒适感显著优于对照组;受压局部SpO2明显高于对照组(P<0.05,P<0.01)。结论赛肤润作为局部预防压疮产品,可明显改善受压局部氧供,减轻局部不适。     

目标导向液体治疗在B型主动脉夹层患者冠状动脉搭桥手术中的疗效分析

目的 探讨目标导向液体治疗在B型主动脉夹层患者冠状动脉搭桥手术中的疗效。方法 收集2019年6月至2022年6月于河北医科大学第一医院接受冠状动脉搭桥手术治疗的82例B型主动脉夹层患者的临床资料,按照治疗方法的不同将其分为观察组(n=50,采用目标导向液体治疗)与对照组(n=32,采用常规液体治疗)。比较两组患者术前30 min(T₀)、麻醉诱导后15 min(T₁)、术中l h(T₂)、术中2 h(T₃)、术毕(T₄)时脑氧饱和度(rSO₂)、中心静脉血氧饱和度(ScvO₂)、容量负荷指标[心排血量(CO)、每搏量变异度(SVV)]、血流动力学指标[平均动脉压(MAP)、心率(HR)、心排血指数(CI)、中心静脉压(CVP)]、血乳酸(LAC)水平及术后并发症发生情况。结果 两组患者手术时间、术中低体温、术中出血量比较,差异均无统计学意义(P﹥0.05)。T₂～T₄时,观察组患者CO、rS...     

静脉麻醉复合切口局部浸润麻醉用于老年股骨颈骨折手术的效果

目的 评价静脉麻醉复合切口局部浸润麻醉用于老年股骨颈骨折手术的效果。方法 择期全麻下行手术治疗的老年股骨颈骨折患者94例,性别不限,年龄61～79岁,体质量45～80 kg;伤后至入院时间1～8 h, ASA分级Ⅰ～Ⅱ级。采用随机数字表法分为静脉麻醉复合切口局部浸润麻醉组(观察组)和单纯静脉麻醉组(对照组),各47例。比较2组患者的麻醉苏醒情况和麻醉诱导前(T₀)、术毕拔管时(T₁)、出麻醉恢复室时(T₂)的心率(HR)、中心静脉压(CVP)。结果 观察组患者睁眼、拔管,以及麻醉恢复室停留时间均短于对照组,差异有统计学意义(P<0.05)。与T₀时点比较,2组患者T₁、T₂时的HR均下降,CVP均上升,其中观察组患者的变化幅度均小于对照组,差异均有统计学意义(P<0.05)。结论 对行股骨颈骨折手术的老年患者,应用静脉麻醉复合切口局部浸润麻醉,可缩短麻醉苏醒时间,且对麻醉苏醒期患者的HR、CVP影响较小。     

胸腔镜手术中两种阻滞方式联合麻醉的研究

目的 探究胸腔镜手术中两种阻滞方式联合麻醉的效果。方法 选取2021年1月至2023年1月在本院接受胸腔镜手术的患者80例，按照麻醉方式的不同将其分为对照组和观察组，各40例。对照组给予双腔气管插管全身麻醉，观察组给予超声引导下胸椎旁神经阻滞(TPVB)联合胸内迷走神经阻滞麻醉。比较两组患者麻醉效果、血气分析指标、氧化应激及疼痛因子水平。结果 观察组麻醉优良率显著高于对照组(P<0.05)。两组患者手术开始30 min的动脉血氧分压(PaO₂)、血氧饱和度(Sp O₂)水平显著高于麻醉前(P<0.05)，动脉血二氧化碳分压(PaCO₂)水平显著低于麻醉前(P<0.05)，手术结束20 min的PaO₂、SpO₂水平显著低于手术开始30 min(P<0.05),PaCO₂水平显著高于手术开始30 min(P<0.05)，且观察组手术开始30 min的PaO₂、SpO₂水平显著低于对照组...     

右美托咪定对腹腔镜前列腺癌根治术老年患者局部脑氧饱和度和术后认知功能的影响

目的观察右美托咪定对腹腔镜前列腺癌根治术老年患者对局部脑氧饱和度(rSO_2)和术后认知功能的影响。方法选择择期行腹腔镜前列腺癌根治手术的老年患者60例,年龄65~80岁,ASA分级Ⅰ~Ⅲ级,随机均分为两组:右美托咪定组(D组)在全麻诱导插管后泵注右美托咪定0.5μg/kg,10min泵注完毕,然后以0.5μg·kg~(-1)·h~(-1)的速度持续泵注至手术结束前30min,对照组(C组)泵入等量的生理盐水。术中使用FORE-SIGHT_脑氧饱和度监测仪监测rSO_2。记录入室时(T_0)、诱导插管后(T_1)、气腹后60min(T_2)和苏醒后(T_3)的rSO_2、MAP、PaCO_2和PaO_2。记录丙泊酚和瑞芬太尼的使用情况、术后躁动和恶心呕吐的发生情况。于术前1d、术后1d和3d使用蒙特利尔认知功能评分量表(MoCA)进行评分,记录患者术后认知功能障碍(POCD)发生情况。结果T_2时两组rSO_2、PaCO_2明显高于T_1时(P0.05)。D组患者丙泊酚和瑞芬太尼用量明显少于C组(P0.05)。D组MoCA评分明显高于C组(P0.05);D组2例(6.7%)患者发生POCD,明显低于C组的9例(30%)(P0.05)。结论右美托咪定用于老年患者腹腔镜前列腺癌根治手术对rSO_2未见明显影响,但可以减少POCD的发生。     

沙滩椅体位及控制性降压下肩关节手术病人脑氧饱和度与脑部血流速度改变及其对术后神经认知的影响

目的 分析沙滩椅体位及控制性降压下肩关节手术中脑氧饱和度(r Sc O2)与脑部血流速度的变化,及其对病人术后神经认知的影响。方法 选取拟于本院以沙滩椅体位接受肩关节手术治疗的病人60例,均为美国麻醉医师协会(ASA)分级Ⅰ、Ⅱ级,在静脉全身麻醉及控制性降压干预下,于麻醉前、麻醉并转入沙滩椅体位后5 min、手术开始时以及手术开始后每隔20 min直至手术结束进行rScO₂、大脑中动脉血流速度(VMCA)和有创血压(心脏水平和耳道水平)的检测,并记录脑氧欠饱和事件(CDE)的发生。同时,于术前和术后24 h对病人进行神经认知能力测试。结果 转入沙滩椅体位后所有病人的rScO₂和VMCA相比麻醉前都有所下降。经历CDE的病人耳道水平平均动脉压、rScO₂和VMCA均显著低于未经历CDE的病人,并且术后24 h时连线测试成绩也更低,组间差异有统计学意义(P<0.05)。结论 对于ASA分级Ⅰ、Ⅱ级病人,沙滩椅体位及控制性降压下肩关节手术中部分病人的rScO₂和VMCA较麻醉前显著下降并发生CDE,...     

袋鼠式护理对无创机械通气早产儿呼吸功能的影响

目的探讨袋鼠式护理对无创机械通气早产儿呼吸功能的影响。方法将64例无创机械通气的早产儿随机分为对照组和干预组各32例。对照组实施常规护理,干预组在对照组基础上实施袋鼠式护理。比较两组早产儿生理指标,撤机后24h内的血气分析值,撤机后7d内的撤机失败率及无创呼吸机带机时间。结果干预组在第1、3、5、7天实施袋鼠式护理2h时的呼吸、心率显著低于对照组,SpO₂显著高于对照组(均P<0.01);干预组撤机后24h内PaCO₂显著低于对照组,PaO₂及SaO₂显著高于对照组(P<0.05,P<0.01);干预组带机时间显著短于对照组(P<0.05)。结论袋鼠式护理可提高无创机械通气早产儿氧合能力,改善其呼吸功能,缩短带机时间。     

心肺转流期间平均动脉压对瓣膜置换术患者脑功能的影响

目的 探讨瓣膜置换术心肺转流(CPB)期间两种不同MAP对局部脑氧饱和度(rScO2)、特异性神经元烯醇酶(NSE)浓度及简易精神状态量表(MMSE)评分的影响.方法 选择CPB下行瓣膜置换术患者50例,男23例,女27例,年龄35～74岁,BMI 18.5～24.9 kg/m2,ASAⅡ或Ⅲ级,NYHAⅡ或Ⅲ级.根据...     

无创心排量联合中心静脉血氧饱和度监测对急性返流性胆管炎合并休克早期目标导向性液体复苏的指导作用

目的 探讨无创心排量（cardiac output,CO）联合中心静脉血氧饱和度（central venous oxygen saturation,ScvO₂）监测对急性返流性胆管炎合并休克早期目标导向性液体复苏的指导作用。方法 回顾性分析广州市花都区人民医院肝胆胰外科2015年1月至2019年12月间收治的94例急性返流性胆管炎合并休克患者资料,分为研究组和对照组两组,每组各47例。在指导早期液体复苏的治疗中,对照组监测患者平均动脉压（MAP）及中心静脉压（CVP）完成,研究组通过床旁多普勒无创血流动力学检测仪动态监测患者CO及经中心静脉导管监测患者ScvO₂。比较两组早期容量达标时间、24 h后休克指数变化、治疗后6 h血乳酸清除率,治疗前及治疗后第3、7天APACHE-III评分的变化情况,治疗后并发症发生率和病死率。结果 研究组早期容量达标时间较对照组明显缩短,24 h后休克指数较对照组明显降低,治疗后6 h血乳酸清除率明显高于对照组,且第3、7天的APACHE-III评分较对照组降低（均P＜0.05）;研究组治疗后并发的肝脓肿、肺部感染、急性肾功能衰竭及消化道出血发生率明显低于对照组（P＜0.01）,而脓毒血症发生率及病死率两组无明显差别（P＞0.05）。结论 临床上联合无创心排量和中心静脉血氧饱和度监测对急性返流性胆管炎合并休克患者早期液体管理具有良好指导作用,值得临床推广。     

The accuracy of a fiberoptic oximeter over a wide range of arterial oxygen saturation values in piglets

A piglet model was used to evaluate the accuracy of a fiberoptic oximeter over a wide range of arterial oxygen saturation (SaO₂) values. In eight anaesthetized piglets, the inspired oxygen concentration was varied from 30% to 6% resulting in a SaO₂ range from 100% to 15%. Paired data of the Opticath® fiberoptic catheter, which was placed in the descending aorta, and blood sample SaO₂ values assessed by a multiwavelength oximeter, were analysed. After in vitro calibration according to the manufacturer's instruction, the fiberoptic catheter started to underestimate the SaO₂ below 78%, worsening towards lower SaO₂ values. The overall bias was -3. 4% and the precision 3. 8%. An off-line fit with a non-linear model resulted in a standard deviation of residuals of 2. 6%. After several in vivo calibration adjustments when the Fiberoptic oximeter deviated more than 4% from the blood sample value, the bias was eliminated over the total SaO₂ range and the precision was 3. 7%. The Opticath® fiberoptic oximeter could have an accuracy for the whole SaO₂ range between 15–100% close to the accuracy of the multiwavelength oximeter, when the fiberoptic oximeter is adapted for the underestimation below 78% SaO₂.     

Effects of pulsatile and nonpulsatile perfusion on cerebral regional oxygen saturation and endothelin-1 in tetralogy of fallot infants

Although benefits of pulsatile flow during cardiopulmonary bypass (CPB) in pediatric heart surgery remain controversial and nonpulsatile CPB is still widely used in clinical cardiac surgery, pulsatile CPB must be reconsidered due to its physiologic features. In this study, we aimed to evaluate the effects of pulsatile perfusion (PP) and nonpulsatile perfusion (NP) on cerebral regional oxygen saturation (rSO₂) and endothelin‐1 (ET‐1) in pediatric tetralogy of Fallot (TOF) patients undergoing open heart surgery with CPB. Forty pediatric patients were randomly divided into the PP group (n = 20) and the NP group (n = 20). Pulsatile patients used a modified roller pump during the cross‐clamp period in CPB, while NP patients used a roller pump with continuous flat flow perfusion. The subjects were monitored for rSO₂ from the beginning of the operation until 6 h after returning to the intensive care unit (ICU). We also monitored the hemodynamic status and ET‐1 concentration and plasma free hemoglobin (PFH) in blood samples of all patients over time. Effective PP was monitored in PP patients, and pulse pressure was significantly higher in the PP group than in the NP group (P < 0.01). rSO₂ of the PP group was higher than that of the NP group (P < 0.01) during the cross‐clamp period, and this advantage of PP would be maintained until 2 h after patients returned to the ICU (P < 0.05). ET‐1 level in blood samples was lower at clamping off and CPB weaning and early ICU period in the PP group than in the NP group (P < 0.01), and ET‐1 concentration remained at a normal level after patients were transferred to the ICU 24 h in all patients. PFH levels in the PP group at pre‐clamp off and CPB weaned off were higher than those of the NP group (P < 0.05) in these cyanotic patients. PP can increase rSO₂ and improve microcirculation during cross‐clamping period in TOF pediatric patients, while PP resulted in more severe hemolysis in these cyanotic patients than NP.     

高迁移率族蛋白B1联合肠型脂肪酸结合蛋白对新生儿坏死性小肠结肠炎的诊断价值

目的探究联合检测高迁移率族蛋白B1（HMGB1）、肠型脂肪酸结合蛋白（I-FABP）诊断新生儿坏死性小肠结肠炎（NEC）的价值。 方法选择2016年7月至2018年7月西北妇女儿童医院收治的NEC新生儿119例（NEC组）以及同期非NEC患儿30例（对照组）。运用酶联免疫吸附法（ELISA）检测患儿粪便样本中HMGB1蛋白以及血清中I-FABP蛋白的表达水平,ROC曲线分析单项检测与联合检测对NEC的诊断效能。 结果Bell Ⅲ期NEC患儿的HMGB1、I-FABP蛋白表达水平均显著高于Ⅰ、Ⅱ期患儿（P<0.05）,随着病情加重,蛋白水平呈逐渐上升趋势。NEC组患儿HMGB1、I-FABP蛋白水平显著高于对照组,差异有统计学意义（P<0.05）。联合应用两项指标诊断NEC的敏感度为89.60%,特异度为86.50%,ROC曲线下面积为0.985（P<0.01）,诊断效能明显高于单项检测（P<0.05）。 结论HMGB1、I-FABP联合检测诊断NEC患儿敏感度及特异度高,动态测定HMGB1、I-FABP指标水平,有助于疑似NEC新生儿的早期筛查、治疗以及病程进展的判断。     

Rotavirus-associated necrotizing enterocolitis: an insight into a potentially preventable disease?

Purpose

The aim of this study was to test the hypothesis that rotavirus-associated necrotizing enterocolitis (NEC + RV) differs from NEC associated with other organisms (NEC-RV).

Methods

Neonates with modified Bell stage II or higher NEC were identified. Demographic, clinical, and outcome information was collected prospectively. Fecal specimens from all infants were tested for confirmation of rotavirus infection (RVI) by immunoelectron microscopy (IEM).

Results

Of 2,444 admissions in the neonatal intensive care unit (NICU), 129 (5.3%) had NEC. Thirty-eight (29%) were rotavirus positive. The 2 groups did not differ in maternal or neonatal characteristics. Stage III or higher NEC was more common in the NEC-RV infants (62% v. 39%; P = .032), whereas recurrence was more common in NEC + RV group (P < .0001). The predominant distribution of nondiffuse pneumatosis (n = 52) was right sided in NEC-RV group and left sided in NEC + RV group (P < .0001). Surgical intervention (SI) did not differ between the 2 groups. The complications and mortality rates also were similar. Severe pneumatosis (P = .009) and severe thrombocytopenia (Platelet count < 50,000/mm³; P < .0001) increased, while human milk feedings decreased (P = .022) the odds for surgery. The annual distribution of NEC + RV paralleled RVI in the community.

Conclusions

Generally, NEC + RV is a less severe disease than NEC − RV as classified by modified Bell staging. However, it can reach advanced stages obscuring distinction from NEC − RV. Indications for surgery should not be altered by identification of RVI in these infants. Monitoring RVI in the community, adhering to infection control measures, human milk feedings, and improving neonatal immunity against RVI may reduce the incidence of NEC + RV.     

不同呼气末二氧化碳分压对室间隔缺损修补术患儿脑氧合及脑血流的影响

目的探讨不同P_(ET)CO_2对室间隔缺损修补术患儿脑氧合及脑血流的影响。方法择期行室间隔缺损修补术患儿60例,随机分为两组,每组30例。低通气组(L组):调控V_T和RR,以维持P_(ET)CO_2在40～45 mmHg;高通气组(H组):调控V_T和RR,以维持P_(ET)CO_2在35～40 mmHg。记录麻醉诱导后(T_0)、开心包(T_1)、CPB结束(T_2)、改良超滤结束(T_3)、术毕(T_4)时的局部脑氧饱和度(rScO_2)以及右侧大脑中动脉血流平均速度(V_(MCA))、搏动指数(PI)和阻力指数(RI)。结果与T_2时比较,T_0、T_1、T_3、T_4时两组患儿rScO_2和V_(MCA)明显升高(P0.05),PI和RI明显降低(P0.05)。T_0、T_1、T_3、T_4时L组rScO_2和V_(MCA)明显高于H组(P0.05)。结论 P_(ET)CO_2在40～45 mmHg时,患儿rScO_2和V_(MCA)高于P_(ET)CO_2在35～40 mmHg时,可改善脑氧供需平衡。     

Use of near-infrared spectroscopy to monitor regional cerebral oxygen saturation during infrarenal aortic crossclamping in piglets

PURPOSE: The hemodynamic changes induced by infrarenal aortic crossclamping have been well documented, but the effects of such crossclamping on cerebral perfusion are unknown. To investigate these effects, we used near-infrared spectroscopy (NIRS) to monitor regional cerebral oxygen saturation (rSO2) during infrarenal aortic crossclamping in a piglet model. METHODS: The study involved 19 piglets, each weighing 7.8 +/- 1 kg. The NIRS sensor was placed on each animal's forehead. General anesthesia was induced, and the infrarenal abdominal aorta was mobilized through a laparotomy. After heparin (1 mg/kg) was administered, crossclamps were applied proximally and distally. A 2 mm segment was resected from the proximal aortic stump, and an aorto-aortic anastomosis was performed. RESULTS: Crossclamping lasted for 30.6 +/- 6.7 min. Between the time of baseline measurement and clamp application, the rSO2 did not decrease significantly (65.4%+/- 8.9% vs. 62.4%+/- 7.8%). However, significant decreases in the rSO2 occurred between baseline measurement and clamp removal (65.4%+/- 8.9% vs. 55.7%+/- 8.9%; P<0.01), between baseline measurement and the end of surgery (65.4%+/- 8.9% vs. 57.7%+/- 7.5%; P<0.01), and between clamp application and removal (62.4%+/- 7.8% vs. 55.7%+/- 8.9%; P<0.01). At these same intervals, no intergroup differences occurred in the temperature, heart rate, or mean arterial pressure. CONCLUSION: Infrarenal aortic crossclamping significantly decreases the rSO2. NIRS, which has the advantages of being non-invasive and continuous, may be useful for monitoring this variable intraoperatively.     

Continuous Metabolic Monitoring in Infant Cardiac Surgery: Toward an Individualized Cardiopulmonary Bypass Strategy

Cardiopulmonary bypass (CPB) in infants is associated with morbidity due to systemic inflammatory response syndrome (SIRS). Strategies to mitigate SIRS include management of perfusion temperature, hemodilution, circuit miniaturization, and biocompatibility. Traditionally, perfusion parameters have been based on body weight. However, intraoperative monitoring of systemic and cerebral metabolic parameters suggest that often, nominal CPB flows may be overestimated. The aim of the study was to assess the safety and efficacy of continuous metabolic monitoring to manage CPB in infants during open‐heart repair. Between December 2013 and October 2014, 31 consecutive neonates, infants, and young children undergoing surgery using normothermic CPB were enrolled. There were 18 male and 13 female infants, aged 1.4 ± 1.7 years, with a mean body weight of 7.8 ± 3.8 kg and body surface area of 0.39 m². The study was divided into two phases: (i) safety assessment; the first 20 patients were managed according to conventional CPB flows (150 mL/min/kg), except for a 20‐min test during which CPB was adjusted to the minimum flow to maintain MVO₂ >70% and rSO₂ >45% (group A); (ii) efficacy assessment; the following 11 patients were exclusively managed adjusting flows to maintain MVO2 >70% and rSO2 >45% for the entire duration of CPB (group B). Hemodynamic, metabolic, and clinical variables were compared within and between patient groups. Demographic variables were comparable in the two groups. In group A, the 20‐min test allowed reduction of CPB flows greater than 10%, with no impact on pH, blood gas exchange, and lactate. In group B, metabolic monitoring resulted in no significant variation of endpoint parameters, when compared with group A patients (standard CPB), except for a 10% reduction of nominal flows. There was no mortality and no neurologic morbidity in either group. Morbidity was comparable in the two groups, including: inotropic and/or mechanical circulatory support (8 vs. 1, group A vs. B, P = 0.07), reexploration for bleeding (1 vs. none, P = not significant [NS]), renal failure requiring dialysis (none vs. 1, P = NS), prolonged ventilation (9 vs. 4, P = NS), and sepsis (2 vs. 1, P = NS). The present study shows that normothermic CPB in neonates, infants, and young children can be safely managed exclusively by systemic and cerebral metabolic monitoring. This strategy allows reduction of at least 10% of predicted CPB flows under normothermia and may lay the ground for further tailoring of CPB parameters to individual patient needs.