Abstract 14202: Perioperative Metabolites Are Associated With Neurodevelopmental Outcomes at One Year in Neonates Undergoing Cardiopulmonary Bypass

• Published in: Circulation (New York, N.Y.) Vol. 144; no. Suppl_1
• Main Authors: Heibel, Jessica, Reuland, Carolyn, Graham, Eric M, ROUX, Aurelie, Graham, David, Manlhiot, Cedric, Everett, Allen D
• Format: Journal Article
• Language: English
• Published: 16.11.2021
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.144.suppl_1.14202

Abstract only Introduction: Improving neurodevelopmental (ND) outcomes for children with congenital heart disease has become a priority. Known clinical and surgical risk factors do not fully capture differences in ND outcomes. The objective of this study was to determine if plasma metabolites at the time of neonatal cardiac surgery were association with ND outcomes at 1 year. Methods: A secondary analysis of a clinical trial in 110 neonates undergoing cardiac surgery was performed. Plasma samples obtained pre-op, immediately post-op and at 12 hours post op had LC/MS/MS metabolomic profiling with a 193-plex targeted metabolite assay covering >366 metabolic pathways. Metabolite levels were compared to one-year neurodevelopmental outcomes measured by the Bayley Scales of Infant and Toddler Development III (BSID). Results: 40/193 metabolites were detected and quantified for analysis. Regression models utilizing metabolites and metabolite features identified associations with cognitive (n=5), language (n=4) and motor (n=10) BSID composite scores. Enrichment analysis disease pathways included seizures (tyrosine and isoleucine) and indoxyl sulfate, a known neurotoxic product from tryptophan synthesis. Conclusions: Perioperative metabolites may serve as biomarkers for prediction of 1-year ND outcomes and provide a scientific basis for targeted interventions to optimize perioperative care.