| |||
Cerebral Oximetry (cerebral + oximetry)
Selected AbstractsThe Use of Cerebral Oximetry as a Monitor of the Adequacy of Cerebral Perfusion in a Patient Undergoing Shoulder Surgery in the Beach Chair PositionPAIN PRACTICE, Issue 4 2009Gregory W. Fischer MD Abstract Four cases of ischemic injury have been reported in patients undergoing orthopedic surgery in the upright position. We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63-year-old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (SctO2) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end-tidal carbon dioxide was accompanied by an increase in SctO2. Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients. [source] Use of Cerebral Oximetry for Monitoring Cardiac Output During Off-Pump Implantation of Jarvik 2000 Left Ventricular Assist DeviceARTIFICIAL ORGANS, Issue 3 2010Helena Argiriadou MD No abstract is available for this article. [source] The Use of Cerebral Oximetry as a Monitor of the Adequacy of Cerebral Perfusion in a Patient Undergoing Shoulder Surgery in the Beach Chair PositionPAIN PRACTICE, Issue 4 2009Gregory W. Fischer MD Abstract Four cases of ischemic injury have been reported in patients undergoing orthopedic surgery in the upright position. We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63-year-old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (SctO2) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end-tidal carbon dioxide was accompanied by an increase in SctO2. Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients. [source] Cerebral oximetry improves detection of sickle cell patients at risk for nocturnal cerebral hypoxia,PEDIATRIC PULMONOLOGY, Issue 11 2006Ashok B. Raj MD Abstract We previously used cerebral oximetry to identify low cerebral venous oxygen saturation in waking children with sickle cell disease (SCD). Because arterial oxyhemoglobin desaturation is common during sleep in SCD patients, this study compared both waking and sleeping systemic arterial and cerebral venous oxygenation dynamics in children with and without SCD. Seventeen African-American (AA) children with homozygous SCD [8 (4,15) years; 29% male; normal transcranial Doppler velocities] were compared with a control cohort (CON) comprised of six healthy AA children [9 (4,16) years, 33% male]. Standard all-night polysomnographic recordings were performed, including measurement of arterial oxygen saturation by pulse oximetry (SpO2). Regional cerebral oxygen saturation (rSO2) was measured non-invasively with cerebral oximetry. Intra-cohort comparisons examined the influence of sleep on SpO2 and rSO2 in the subjects. Inter-cohort comparisons of SpO2, rSO2, and the rSO2/SpO2 ratio assessed the impact of SCD on systemic and cerebral oxygenation during wakefulness and sleep. Cohort differences in SpO2 were not statistically significant in either wakefulness or sleep. However, only in the SCD cohort was the magnitude of SpO2 change statistically significant (P,=,0.002). In contrast, both waking and sleep rSO2 cohort median values did differ significantly [awake: CON 76 (67,86) vs. SCD 62 (58,71), P,=,0.01; sleep: CON 65 (60,77) vs. SCD 55 (48,61), P,=,0.01)]. The waking rSO2/SpO2 ratio was also significantly lower in the SCD group [CON 0.78 (0.68,0.88) vs. SCD of 0.66 (0.61,0.72); P,=,0.015]. During sleep, the ratio was also significantly lower in the SCD group [CON 0.71 (0.66,0.81) vs. SCD 0.59 (0.52,0.65); P,=,0.011]. Our findings suggest that SCD patients may be at increased risk of cerebral hypoxia during both wakefulness and sleep. Pediatr Pulmonol. 2006, 41:1088,1094. © 2006 Wiley-Liss, Inc. [source] The Use of Cerebral Oximetry as a Monitor of the Adequacy of Cerebral Perfusion in a Patient Undergoing Shoulder Surgery in the Beach Chair PositionPAIN PRACTICE, Issue 4 2009Gregory W. Fischer MD Abstract Four cases of ischemic injury have been reported in patients undergoing orthopedic surgery in the upright position. We describe the use of cerebral oximetry as a monitor of the adequacy of cerebral perfusion in a 63-year-old woman who underwent arthroscopic rotator cuff surgery in a beach chair under general anesthesia. During positioning, a decrease in blood pressure was accompanied by a decrease in cerebral oxygen saturation (SctO2) and was treated with phenylephrine. When spontaneous ventilation resumed, an increase in end-tidal carbon dioxide was accompanied by an increase in SctO2. Cerebral oximetry may prove useful as a guide monitor and manage nonsupine patients. [source] A noninvasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patientsPEDIATRIC ANESTHESIA, Issue 6 2005TIA A. TORTORIELLO MD FAAP Summary Background :,Near-infrared spectroscopy (NIRS) is a noninvasive optical monitor of regional cerebral oxygen saturation (rSO2). The aim of this study was to validate the use of NIRS by cerebral oximetry in estimating invasively measured mixed venous oxygen saturation (SvO2) in pediatric postoperative cardiac surgery patients. Methods :,Twenty patients were enrolled following cardiac surgery with intraoperative placement of a pulmonary artery (PA) or superior vena cava (SVC) catheter. Five patients underwent complete biventricular repair , complete atrioventricular canal (n = 3) and other (n = 2). Fifteen patients with functional single ventricle underwent palliative procedures , bidirectional Glenn (n = 11) and Fontan (n = 4). Cerebral rSO2 was monitored via NIRS (INVOS 5100) during cardiac surgery and 6 h postoperatively. SvO2 was measured from blood samples obtained via an indwelling PA or SVC catheter and simultaneously correlated with rSO2 by NIRS at five time periods: in the operating room after weaning from cardiopulmonary bypass, after sternal closure, and in the CICU at 2, 4, and 6 h after admission. Results :,Each patient had five measurements (total = 100 comparisons). SvO2 obtained via an indwelling PA or SVC catheter for all patients correlated with rSO2 obtained via NIRS: Pearson's correlation coefficient of 0.67 (P < 0.0001) and linear regression of r2 = 0.45 (P < 0.0001). Separate linear regression of the complete biventricular repairs demonstrated an r = 0.71, r2 = 0.50 (P < 0.0001). Bland,Altman analysis showed a bias of +3.3% with a precision of 16.6% for rSO2 as a predictor of SvO2 for all patients. Cerebral rSO2 was a more accurate predictor of SvO2 in the biventricular repair patients (bias ,0.3, precision 11.8%), compared with the bidirectional Glenn and Fontan patients. Conclusions :,Regional cerebral oximetry via NIRS correlates with SvO2 obtained via invasive monitoring. However, the wide limits of agreement suggest that it may not be possible to predict absolute values of SvO2 for any given patient based solely on the noninvasive measurement of rSO2. Near-infrared spectroscopy, using the INVOS 5100 cerebral oximeter, could potentially be used to indicate trends in SVO2, but more studies needs to be performed under varying clinical conditions. [source] Cerebral oximetry improves detection of sickle cell patients at risk for nocturnal cerebral hypoxia,PEDIATRIC PULMONOLOGY, Issue 11 2006Ashok B. Raj MD Abstract We previously used cerebral oximetry to identify low cerebral venous oxygen saturation in waking children with sickle cell disease (SCD). Because arterial oxyhemoglobin desaturation is common during sleep in SCD patients, this study compared both waking and sleeping systemic arterial and cerebral venous oxygenation dynamics in children with and without SCD. Seventeen African-American (AA) children with homozygous SCD [8 (4,15) years; 29% male; normal transcranial Doppler velocities] were compared with a control cohort (CON) comprised of six healthy AA children [9 (4,16) years, 33% male]. Standard all-night polysomnographic recordings were performed, including measurement of arterial oxygen saturation by pulse oximetry (SpO2). Regional cerebral oxygen saturation (rSO2) was measured non-invasively with cerebral oximetry. Intra-cohort comparisons examined the influence of sleep on SpO2 and rSO2 in the subjects. Inter-cohort comparisons of SpO2, rSO2, and the rSO2/SpO2 ratio assessed the impact of SCD on systemic and cerebral oxygenation during wakefulness and sleep. Cohort differences in SpO2 were not statistically significant in either wakefulness or sleep. However, only in the SCD cohort was the magnitude of SpO2 change statistically significant (P,=,0.002). In contrast, both waking and sleep rSO2 cohort median values did differ significantly [awake: CON 76 (67,86) vs. SCD 62 (58,71), P,=,0.01; sleep: CON 65 (60,77) vs. SCD 55 (48,61), P,=,0.01)]. The waking rSO2/SpO2 ratio was also significantly lower in the SCD group [CON 0.78 (0.68,0.88) vs. SCD of 0.66 (0.61,0.72); P,=,0.015]. During sleep, the ratio was also significantly lower in the SCD group [CON 0.71 (0.66,0.81) vs. SCD 0.59 (0.52,0.65); P,=,0.011]. Our findings suggest that SCD patients may be at increased risk of cerebral hypoxia during both wakefulness and sleep. Pediatr Pulmonol. 2006, 41:1088,1094. © 2006 Wiley-Liss, Inc. [source] |