Utility of Cerebral Oxymetry for Assessing Cerebral Arteriolar Carbon Dioxide Reactivity during Cardiopulmonary Bypass

Aritürk, Cem; Ökten, Murat; Özgen, Zehra Serpil Ustalar; Erkek, Esin; Pinar, Uysal; Gullu, Umit; Şenay, Şahin; Karabulut, Hasan; Alhan, Cem; Toraman, Fevzi

doi:10.1532/hsf98.2014319

Cited by 4 publications

(2 citation statements)

References 21 publications

(21 reference statements)

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“…Arituk et al . have shown in 126 patients that cerebral StcO 2 decreased to 10% when the mean PaCO 2 decreased from 38 to 30 mmHg without a corresponding alteration of arterial oxygen, lactate, mean arterial pressure or blood flow on the extracorporeal support [26]. The authors concluded that there was a vasoconstriction effect on cerebral arteries.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

et al. 2017

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ObjectivesExtracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2) on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions.Study designThis was a prospective study in infants < 3 months of age admitted to a pediatric intensive care unit and requiring ECMO support.MeasurementsThe assessment of cerebral perfusion was made by continuous StcO2 monitoring using near-infrared spectroscopy (NIRS) sensors placed on the two temporo-parietal regions. Neurological lesions were identified by MRI or transfontanellar echography.ResultsThirty-four infants <3 months of age were included in the study over a period of 18 months. The ECMO duration was 10±7 days. The survival rate was 50% (17/34 patients), and the proportion of brain injuries was 20% (7/34 patients). The mean StcO2 during ECMO in the non-survivors was reduced in both hemispheres (p = 0.0008 right, p = 0.03 left) compared to the survivors. StcO2 was also reduced in deceased or brain-injured patients compared to the survivors without brain injury (p = 0.002).ConclusionStcO2 appears to be a strong prognostic factor of survival and of the presence of cerebral lesions in young infants during ECMO.

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Section: Discussionmentioning

confidence: 99%

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

et al. 2017

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“…However, in the case of hypoxaemia, the hypoxaemic stimulus provokes hyperventilation, which may explain why arterial carbon dioxide may decrease. Interestingly, parallel changes in PaCO 2 and TOI have been observed during cardiopulmonary bypass (Ariturk et al ., ), but the correlations between PtcCO 2 , SpO 2 and TOI are complex, not only because of the inter‐relation between breathing pattern and gas exchange (Heine et al ., ), but also the different time lags between PtcCO 2 , SpO 2 and TOI changes. Indeed, changes in PtcCO 2 have a longer time delay than those in SpO 2 and TOI, which are instantaneous.…”

Section: Discussionmentioning

confidence: 99%

A comparison of pulse oximetry and cerebral oxygenation in children with severe sleep apnea–hypopnea syndrome: a pilot study

Arroyo

Khirani

Amaddeo

et al. 2017

Journal of Sleep Research

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Near infrared spectroscopy (NIRS) has been used to assess the impact of obstructive sleep apnea-hypopnea syndrome (OSAHS) on cerebral oxygenation. However, the relationship between the variations in the cerebral tissue oxygen saturation (ΔTOI) and pulse oximetry (ΔSpO ) has not been assessed in children with OSAHS. Consecutive clinically stable children with severe OSAHS [apnea-hypopnea index (AHI) >15 events h ] diagnosed during a night-time polygraphy with simultaneous recording of cerebral oxygenation with NIRS (NIRO-200NX, Hamamatsu Photonics KK) were included between September 2015 and June 2016. Maximal ΔSpO (SpO drop from the value preceding desaturation to nadir) and concomitant variations in transcutaneous carbon dioxide (ΔPtcCO ), maximal ΔTOI and maximal variations in cerebral oxygenated (O Hb) and deoxygenated (HHb) haemoglobin were reported. The relationships between ΔSpO , ΔPtcCO and ΔTOI, ΔO Hb and ΔHHb were investigated. The data from five children (three boys, aged 9.6 ± 6.7 years, AHI 16-91 events h ) were analysed. Strong correlations were found between ΔSpO and ΔTOI (r = 0.887, P < 0.001), but also with ΔO Hb and ΔHHb with a particular pattern in the youngest child with a dark skin pigmentation. Mean ΔSpO was 20 ± 17% and mean ΔTOI was 8 ± 7%. Maximal ΔSpO of approximately 70% were coupled with ΔTOI of no more than 35%. ΔPtcCO correlated only weakly with the cerebral oxygenation indexes. This pilot study shows a strong relationship between pulse oximetry and cerebral oxygenation in children with OSAHS, with lower changes in TOI compared to SpO . Future studies should address the clinical impact of respiratory events on cerebral oxygenation and its consequences.

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Central Nervous System Near-Infrared Spectroscopic Monitoring: Technique and Clinical Application

Beltran

Vazquez-Colon

Baines

et al. 2022

Koht, Sloan, Toleikis's Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals

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Utility of Cerebral Oxymetry for Assessing Cerebral Arteriolar Carbon Dioxide Reactivity during Cardiopulmonary Bypass

Cited by 4 publications

References 21 publications

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

A comparison of pulse oximetry and cerebral oxygenation in children with severe sleep apnea–hypopnea syndrome: a pilot study

Central Nervous System Near-Infrared Spectroscopic Monitoring: Technique and Clinical Application

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