Cerebral oxygenation assessed by near-infrared spectroscopy in the sitting and prone positions during posterior fossa surgery: a prospective, randomized clinical study

Dilmen, Özlem Korkmaz; Akçıl, Eren Fatma; Vehid, Hayriye Ertem; Tunalı, Yusuf

doi:10.1016/j.bjane.2021.09.016

Cited by 2 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another study found a gradual reduction in rSO2 in sitting and prone positions during posterior fossa surgery without any statistical difference between them. MAP was found to be lower in sitting position as compared to prone [ 25 ]. The authors speculated that even though the MAP was maintained >55 mmHg, minimal elevation of the lower limit of MAP would have improved rSO2 values in the sitting position [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Cerebral Perfusion Pressure, Cerebral Blood Flow, and Cerebral Oxygenation at Different Head of Bed Positions Using Transcranial Doppler and Near-Infrared Spectroscopy in Postoperative Neurosurgical Patients

Baskar,

Sethuraman,

Praveen

et al. 2024

Cureus

View full text Add to dashboard Cite

Objectives: Nursing postoperative neurosurgical patients with head of bed (HOB) elevation beyond 30° might be desired at times to prevent pulmonary complications. Due to the paucity of studies determining the effect of HOB beyond 30° on cerebral perfusion pressure (CPP), cerebral blood flow (CBF), and regional cerebral oxygenation (rSO2), this study was designed. Methods: A total of 40 patients following elective neurosurgery for supratentorial tumors were studied in the neurosurgical intensive care unit three hours following admission. They were assessed for CBF velocities of middle cerebral arteries on either side using transcranial color Doppler (TCCD), rSO2 using near-infrared spectroscopy (NIRS), and mean arterial pressure measured at tragus level at various HOB positions. The estimated cerebral perfusion pressure (CPPe) was calculated from TCCD parameters, and the estimated intracranial pressure (ICPe) was then derived. Their variations at different HOB positions were noted. Results: TCCD parameters such as peak systolic velocity (PSV) and mean flow velocity (MFV) did not significantly vary upon elevating HOB from 0° to 30° but reduced significantly when HOB was further elevated to 60° (p < 0.05). ICPe reduced significantly with a change of HOB positions from 0° to 60° (p < 0.001), and a significant reduction in CPPe was noticed when HOB was elevated to 60° (67.2 ± 10.1 mmHg vs. 74.7 ± 11.2 mmHg at 0°). However, none of these HOB positions affected rSO2 values. Conclusion: Postoperative nursing with positions up to 60° HOB can be tried in indicated patients following elective neurosurgery when complemented with CBF velocity and rSO2 monitoring and in whom CPP-guided therapy is not preferred.

show abstract

Section: Discussionmentioning

confidence: 99%

“…MAP was found to be lower in sitting position as compared to prone [ 25 ]. The authors speculated that even though the MAP was maintained >55 mmHg, minimal elevation of the lower limit of MAP would have improved rSO2 values in the sitting position [ 25 ].…”

Section: Discussionmentioning

confidence: 99%