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Cerebral Oxygen Saturation (cerebral + oxygen_saturation)
Kinds of Cerebral Oxygen Saturation Selected AbstractsSurgical closure of patent ductus arteriosus reduces the cerebral tissue oxygenation index in preterm infants: a near-infrared spectroscopy and Doppler studyPEDIATRICS INTERNATIONAL, Issue 3 2006PATRIZIA ZARAMELLA Abstract Background: The aim of this study was to investigate the effects of patent ductus arteriosus (PDA) ligature on cerebral oxygen saturation, cerebral blood volume (CBV) and cerebral blood flow velocity by means of near-infrared spectroscopy (NIRS) and transcranial Doppler simultaneous examinations. Methods: This is an observational study considering 16 babies of gestational age 24,34 weeks diagnosed with PDA who underwent surgical ligation. The cerebral oxygen saturation, CBV and blood gases values were obtained 35 min before ligation, so also around the 14th and 27th min after the clip's insertion. Results: Cerebral oxygen saturation, measured as tissue oxygenation index (TOI), decreased significantly after PDA ligation from a basal value of 61.1 (3.8) before surgery to 56.6 (3.3) and 55.8 (2.6)%, for the 14th and 27th min, respectively (P < 0.04). CBV before and after clipping was unvaried. A negative correlation was found between ,pH and ,CBV after ligation (R = 0.52, P = 0.03), whilst a positive correlation was found between ,CBV and ,PaCO2 (R = 0.62, P = 0.009). pH increased at the 27th min post-ligation. Conclusions: NIRS is a tool for obtaining information on cerebral oxygen saturation and CBV changes during surgical PDA ligation at the bedside. A fall in TOI suggests an increased oxygen extraction during PDA surgery. The lack of increase in ,CBV or in diastolic flow velocity show that the PDA before the clipping did not limit cerebral blood flow, the drop in TOI suggests increased oxygen consumption over the clip and the need for accurate monitoring of oxygen utilization after the surgical treatment. [source] The effect of pneumoperitoneum in the steep Trendelenburg position on cerebral oxygenationACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2009E. Y. PARK Background: daVinci® robot-assisted laparoscopic radical prostatectomy (RALP) requires pneumoperitoneum in the steep Trendelenburg position, which results in increased intracranial pressure and cerebral blood flow. The aim of this study was to evaluate the effect of pneumoperitoneum in a 30° Trendelenburg position on cerebral oxygenation using regional cerebral oxygen saturation (rSO2). Methods: Thirty-two male patients of ASA I and II physical status without previous episodes of cerebral ischemia or hemorrhage undergoing daVinci® RALP were enrolled. The rSO2 was continuously monitored with near-infrared spectroscopy (INVOS® 5100Ô) during the study period. Measurements were obtained immediately after anesthesia induction (T0; baseline), 5 min after a 30° Trendelenburg position (T1), 5 min after 15 mmHg pneumoperitoneum in a supine position (T2), 30, 60 and 120 min after the pneumoperitoneum in a Trendelenburg position (T3, T4 and T5, respectively) and after desufflation in a supine position (T6). Results: The change in the left and right rSO2 was statistically significant (Left P=0.004 and Right P=0.023). Both the right and the left rSO2 increased significantly during pneumoperitoneum in a Trendelenburg position (from T3 to T5) and at T6 compared with the baseline value at T0. The partial pressure of carbon dioxide (PaCO2) was increased significantly at T2, T3, T5 and T6 compared with the baseline value at T0. Conclusions: During daVinci® RALP, cerebral oxygenation, as assessed by rSO2, increased slightly, which suggests that the procedure did not induce cerebral ischemia. The PaCO2 should be maintained within the normal limit during pneumoperitoneum in a Trendelenburg position in patients undergoing daVinci® RALP because the rSO2 increased in conjunctions with the increase in PaCO2. [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] Surgical closure of patent ductus arteriosus reduces the cerebral tissue oxygenation index in preterm infants: a near-infrared spectroscopy and Doppler studyPEDIATRICS INTERNATIONAL, Issue 3 2006PATRIZIA ZARAMELLA Abstract Background: The aim of this study was to investigate the effects of patent ductus arteriosus (PDA) ligature on cerebral oxygen saturation, cerebral blood volume (CBV) and cerebral blood flow velocity by means of near-infrared spectroscopy (NIRS) and transcranial Doppler simultaneous examinations. Methods: This is an observational study considering 16 babies of gestational age 24,34 weeks diagnosed with PDA who underwent surgical ligation. The cerebral oxygen saturation, CBV and blood gases values were obtained 35 min before ligation, so also around the 14th and 27th min after the clip's insertion. Results: Cerebral oxygen saturation, measured as tissue oxygenation index (TOI), decreased significantly after PDA ligation from a basal value of 61.1 (3.8) before surgery to 56.6 (3.3) and 55.8 (2.6)%, for the 14th and 27th min, respectively (P < 0.04). CBV before and after clipping was unvaried. A negative correlation was found between ,pH and ,CBV after ligation (R = 0.52, P = 0.03), whilst a positive correlation was found between ,CBV and ,PaCO2 (R = 0.62, P = 0.009). pH increased at the 27th min post-ligation. Conclusions: NIRS is a tool for obtaining information on cerebral oxygen saturation and CBV changes during surgical PDA ligation at the bedside. A fall in TOI suggests an increased oxygen extraction during PDA surgery. The lack of increase in ,CBV or in diastolic flow velocity show that the PDA before the clipping did not limit cerebral blood flow, the drop in TOI suggests increased oxygen consumption over the clip and the need for accurate monitoring of oxygen utilization after the surgical treatment. [source] Aortic Arch Surgery With a Single Centrifugal Pump for Selective Cerebral Perfusion and Systemic CirculationARTIFICIAL ORGANS, Issue 1 2010Keiji Iwata Abstract In aortic arch surgery, two pumps are required for systemic perfusion and selective cerebral perfusion (SCP). A new technique with a single centrifugal pump for systemic perfusion and SCP was developed and its efficacy and safety evaluated. This technique was adopted for total arch replacement in 22 consecutive patients with true aneurysms (13) and aortic dissection (nine) from January 2005 to January 2008. Cerebral perfusion lines branched from the main perfusion line. During SCP, right radial arterial pressure was maintained at 50 mm Hg and left common carotid arterial pressure at 60 mm Hg, and the regional cerebral oxygen saturation (rSO2) values were maintained at approximately >80% of the baseline value. Two operative deaths (9%) occurred due to pneumonia and hemorrhage in the left lung, respectively. Stroke occurred in one patient (5%). This simple circuit system can thus be easily and safely applied for aortic arch surgery. [source] Haemodynamic changes in the brain after vaginal delivery and caesarean section in healthy term infantsBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2002C. Dani Objective To investigate whether the mode of delivery may affect neonatal cerebral haemodynamics during the first hour of life. Design Prospective study. Sample Healthy infants with gestational age ,37 weeks and birthweight appropriate for gestational age, born after uncomplicated pregnancy by vaginal delivery or elective caesarean section, two to five hours after the delivery. Methods Near infra-red spectroscopy was used to measure changes of oxygenated haemoglobin, deoxygenated haemoglobin, oxidized-reduced cytochrome aa3, and mean cerebral oxygen saturation (mixed cerebral oxygen saturation = oxygenated haemoglobin/total haemoglobin). Changes in cerebral blood volume were calculated. Results Near infra-red spectroscopy data did not show significant differences between infants born by vaginal delivery or by caesarean section. There was a significant decrease of oxygenated haemoglobin and change of cerebral blood volume values at 120 and 180 minutes in both the groups, while deoxygenated haemoglobin and oxidized-reduced cytochrome aa3 were unchanged. Conclusions A decrease of cerebral blood volume occurs after birth and this occurs both in infants born by vaginal delivery and by caesarean section. [source] | ||||||||||