Objective To investigate the effect of circulatory management strategy with regional cerebral oxygen saturation(rScO₂) and central venous-arterial differential pressure of carbon dioxide (Pcv-aCO₂) as the main targets on the short term prognosis of children with cyanotic congenital heart disease (CCHD). Methods A total of 72 children with CCHD aged 0-1 year,who underwent cardiac surgery under cardiopulmonary bypass (CPB) in the Seventh Medical Center of Chinese PLA General Hospital from October 2020 to June 2021, were selected as research objects, and randomly divided into control group (n=36)and intervention group (n=36). The control group was implemented with traditional circulation management strategy, while the intervention group was implemented the individualized circulation management strategy with rScO₂ and Pcv-aCO₂ as the main targets. The mean arterial pressure (MAP) of endotracheal intubation opening the arteries and veins (T₁), 5 minutes after clipping of ascending aorta (T₂), 5 minutes after opening of ascending aorta (T₃), end of ultrafiltration (T₄), 3 hours after end of CPB (T₅),8 hours after end of CPB (T₆) and 24 hours after end of CPB (T₇) of the two groups of children were recorded, respectively, as well as the pharyngeal temperature (T), hemoglobin (Hb), arterial oxygen saturation (SaO₂), partial pressure of carbon dioxide in artery (PaCO₂), rScO₂, Pcv-aCO₂, arterial blood lactate (Lac) and central venous oxygen saturation (ScvO₂), CPB time, operation time, extubation time, ICU stay time, discharge time, and acute kidney injury (AKI), lung infection, and respiratory failure. Results No significant difference existed in MAP, T, Hb and SaO₂ between the two groups at T₁-T₇ (P>0.05). Compared with control group, PaCO₂ in the intervention group was significantly increased at T₂, T₃, T₆ and T₇, rScO₂ was significantly increased at T₃-T₆(P<0.05), and Pcv-aCO₂ was significantly decreased at T₁-T₇ (P<0.05), Lac levels were significantly decreased at T₃ and T₅ (P<0.05),and ScvO₂ levels were significantly decreased at T₂ and T₃ (P<0.05). No significant difference existed in CPB time, operation time,extubation time, postoperative pulmonary infection and respiratory failure rate between the two groups (P>0.05). The ICU stay time and hospital stay time were significantly shorter in intervention group than in control group [(5.67±1.50) d vs. (7.28±2.11) d,P<0.05; (14.67±3.41) d vs. (19.00±2.63) d, P<0.05], the incidence of postoperative AKI was significantly lower than the control group [25.0% (9/36) vs. 50.0% (18/36), P<0.05]. Conclusion The individualized circulatory management strategy with rScO₂ and Pcv-aCO₂ as the main targets in the perioperative period can significantly improve the short term prognosis of children with CCHD.