| Summary: | Background: We investigated preoperative cerebral (ScO<sub>2</sub>) and abdominal (StO<sub>2</sub>) regional oxygen saturations according to cardiac diagnosis in neonates with critical CHD, their time trends, and the clinical and biochemical parameters associated with them. Methods: Thirty-seven neonates with a prenatal diagnosis of CHD were included. ScO<sub>2</sub> and StO<sub>2</sub> values were continuously evaluated using near-infrared spectroscopy. Measurements were obtained hourly before surgery. A linear mixed effects model was used to assess the effects of time and cardiac diagnosis on regional oxygenation and to explore the contributing factors. Results: Regional oxygenation differed according to cardiac diagnosis (<i>p</i> < 0.001). ScO<sub>2</sub> was lowest in the patients with severe atrioventricular valvar regurgitation (AVVR) (48.1 ± 8.0%). StO<sub>2</sub> tended to be lower than ScO<sub>2</sub>, and both worsened gradually during the period between birth and surgery. There was also a significant interaction between cardiac diagnosis and time. The factors related to ScO<sub>2</sub> were hemoglobin and arterial saturation, whereas no factor was associated with StO<sub>2</sub>. Conclusions: Preoperative ScO<sub>2</sub> and StO<sub>2</sub> in critical CHD differed according to cardiac diagnosis. ScO<sub>2</sub> in the patients with severe AVVR was very low, which may imply cerebral hypoxia. ScO<sub>2</sub> gradually decreased, suggesting that the longer the time to surgery, the higher the risk of hypoxic brain injury.
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