Correlação entre a SvO₂ e SjO₂ durante a cirurgia cardíaca com circulação extracorpórea em crianças

Neuroprotective Anesthesia Regimen and Intensive Management for Pediatric Cardiac Surgery with Cardiopulmonary Bypass: a Review and Initial Experience

“…Brain oxygenation monitoring with NIRS or SsvcO 2 (superior vena cava hemoglobin oxygen saturation), largely determined by cerebral venous flow, and real time functional integrity (electroencephalogram (EEG), evoked potentials) monitoring in real time are of primordial importance, and avoid or minimize the use of anesthetic associated with neurotoxicity (apoptosis) such as volatile anesthetics and ketamine should be part of advocated anesthesia cardiac pediatric surgery protocols [ 4 ] . Critical periods of cerebral oxygenation reduction typically occur during the induction of anesthesia when hypotension and decrease of cardiac output take place, cannulation for CPB, low-flow or variable flow during CPB, rewarming and separation from CPB [ 15 ] .…”

“…A 58% reduction of CBF marks the threshold for the installation of ischemia-hypoxia injury associated with a cerebral rSO 2 of less than 50% [ 19 ] . During CPB, the period of rewarming carries the greatest risk for cerebral hypoxia regardless of appropriate SaO 2 [ 15 ] .…”