Association between ambient noise and physiologic changes in neonates with single-ventricle physiology after the Norwood procedure.

OBJECTIVE

To characterize ambient noise and acute physiologic changes in neonates after Stage 1 Norwood palliation.

STUDY

DESIGN

We retrospectively analyzed synchronized sound and physiologic data from 12 neonates >36 weeks' gestation with a Sano or modified Blalock-Taussig-Thomas shunt during the first 48 postoperative hs.

RESULT: Among 1,014,403 audio observations, 25th percentile ambient sound levels were 69.05, 70.35, and 70.75 dBA during postoperative hs 0-12, 12-24, and 24-48, respectively, exceeding published recommendations. Overall, 3936 noisy events were identified. Time in the noisy range increased from 47 min during hs 0-12 to 266 min during hs 24-48. Noisy events were associated with small heart rate increases, somatic near-infrared spectroscopy decreases, and epoch-dependent changes in mean arterial blood pressure.

CONCLUSION

Noisy events were common after Norwood palliation and associated with small physiologic changes consistent with altered systemic perfusion. Prospective studies should evaluate whether noise reduction improves physiologic stability.