Cerebral oximetry monitoring to maintain NORMal Cerebral Oxygen SATuration (NORMOSAT during high-risk cardiac surgery: a randomized controlled feasibility trial

Deschamps, Alain; Denault, André; Grocott, Hilary P.; Médicis, Étienne de; Buissières, J; Hudson, Christopher; Seyed, S; Seal, Douglas; Herd, Stuart; Lambert, Jean

doi:10.1053/j.jvca.2016.03.125

Cited by 42 publications

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“…Furthermore, small differences in ambient and muscular temperature may influence day-today variability, 4 as may slight changes in posture. 38 It is likely that in the present study, controlled environmental conditions, 39 although this has been criticized given the differences in patient skull geometry and consequently light transport. In muscle, the InSpectra used second derivative spectroscopy to calculate a resting TSI in muscle that was suggested to report on tissue dysoxia in shock states.…”

Section: Test-retest Reliability Of Devices At Restmentioning

confidence: 97%

Performance comparison of the MOXY and PortaMon near-infrared spectroscopy muscle oximeters at rest and during exercise

2018

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Abstract. The purpose of the study was to compare muscle oxygenation as measured by two portable, wireless near-infrared spectroscopy (NIRS) devices under resting and dynamic conditions. A recently developed low-cost NIRS device (MOXY) was compared against an established PortaMon system that makes use of the spatially resolved spectroscopy algorithm. The influence of increasing external pressure on tissue oxygen saturation index (TSI) indicated that both devices are stable between 2 and 20 mmHg. However, above this pressure, MOXY reports declining TSI values. Analysis of adipose tissue thickness (ATT) and TSI shows a significant, nonlinear difference between devices at rest. The devices report similar TSI (%) values at a low ATT (<7 mm) (PortaMon minus MOXY difference is þ1.1 AE 2.8%) with the major subsequent change between the devices occurring between 7 and 10 mm; at ATT values >10 mm the difference remains constant (−14.7 AE 2.8%). The most likely explanation for this difference is the small source-detector separation (2.5 cm) in the MOXY resulting in lower tissue penetration into muscle in subjects with higher ATT. Interday test-retest reliability of resting TSI was evaluated on five separate occasions, with the PortaMon reporting a lower coefficient of variation (1.8% to 2.5% versus 5.7% to 6.2%). In studies on male subjects with low ATT, decreases in the TSI were strongly correlated during isometric exercise, arterial occlusion, and incremental arm crank exercise. However, the MOXY reports a greater dynamic range, particularly during ischemia induced by isometric contraction or occlusion (Δ74.3% versus Δ43.7%; hyperemia MAX-occlusion MIN). This study shows that in this subject group both MOXY and PortaMon produce physiologically credible TSI measures during rest and exercise. However, the absolute values obtained during exercise are generally not comparable between devices unless corrected by physiological calibration following an arterial occlusion. © The Authors. Published by SPIE under a Creative Commons Attribution 3.0 Unported License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI.

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Section: Test-retest Reliability Of Devices At Restmentioning

confidence: 97%

Performance comparison of the MOXY and PortaMon near-infrared spectroscopy muscle oximeters at rest and during exercise

2018

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“…Il a été soutenu par la Société canadienne des anesthésiologistes dans ses efforts pour lutter contre les pénuries de médicaments 2 et par le Journal canadien d'anesthésie 2-4 dans sa promotion de la dissémination d'une recherche de haute qualité; son travail original a été publié dans des revues à comité de lecture et à fort impact. 5 Les membres du PACT ont profité du fait qu'ils étaient reconnus comme auteurs de ces publications.…”

Section: Développement De La Recherche Collaborativeunclassified

“…It has supported the Canadian Anesthesiologists' Society in its efforts to combat drug shortages 2 and the Canadian Journal of Anesthesia [2][3][4] in its promotion of the dissemination of high-quality research, and it has published original work in high-impact peerreviewed journals. 5 Members of the PACT have benefitted by being acknowledged as authors.…”

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confidence: 99%

Can we create a Canadian Perioperative Anesthesia Clinical Trials Group? We review the first five years and glimpse into the future

Hall

Beattie

Grocott

et al. 2016

Can J Anesth/J Can Anesth

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“…This technique may lead to increased symmetry of CBF and corresponding improved cerebral oximetry during aortic arch surgery. The degree of asymmetrical desaturation deemed to be significant is not fully known, and as several different thresholds have been used, 6 we arbitrarily chose a 10% reduction from baseline as the point to initiate our intervention.…”

Section: Discussionmentioning

confidence: 99%

External carotid compression: a novel technique to improve cerebral perfusion during selective antegrade cerebral perfusion for aortic arch surgery

Grocott

Ambrose

Moon

2016

Can J Anesth/J Can Anesth

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External carotid compression: a novel technique to improve cerebral perfusion during selective antegrade cerebral perfusion for aortic arch surgery La compression externe de la carotide: une technique innovante pour améliorer la perfusion cérébrale pendant une perfusion cérébrale antérograde sélective pour une chirurgie de la crosse aortique Abstract Purpose Selective antegrade cerebral perfusion (SACP) involving cannulation of either the axillary or innominate artery is a commonly used technique for maintaining cerebral blood flow (CBF) during the use ofhypothermic cardiac arrest (HCA) for operations on the aortic arch. Nevertheless, asymmetrical CBF with hypoperfusion of the left cerebral hemisphere is a common occurrence during SACP. The purpose of this report is to describe an adjunctive maneuver to improve left hemispheric CBF during SACP by applying extrinsic compression to the left carotid artery. Clinical features A 77-yr-old male patient with a history of aortic valve replacement presented for emergent surgical repair of an acute type A aortic dissection of a previously known ascending aortic aneurysm. His intraoperative course included cannulation of the right axillary artery, which was used as the aortic inflow during cardiopulmonary bypass and also allowed for subsequent SACP during HCA. After the onset of HCA, the innominate artery was clamped at its origin to allow for SACP. Shortly thereafter, however, the left-sided cerebral oxygen saturation (SrO 2 ) began to decrease. Augmenting the PaO 2 , PaCO 2 and both SACP pressure and flow failed to increase left hemispheric SrO 2 . Following the use of ultrasound guidance to confirm the absence of atherosclerotic disease in the carotid artery, external pressure was applied partially compressing the artery. With the carotid compression, the left cerebral saturation abruptly increased, suggesting pressurization of the left cerebral hemispheric circulation and augmentation of CBF. Conclusions Direct ultrasound visualization and cautious partial compression of the left carotid artery may address asymmetrical CBF that occurs with SACP during HCA for aortic arch surgery. This strategy may lead to improved symmetry of CBF and corresponding cerebral oximetry measurements during aortic arch surgery. RésuméObjectif La perfusion cérébrale antérograde sélective réalisée via la canulation de l'artère axillaire ou du tronc artériel brachiocéphalique est une technique répandue pour maintenir la circulation sanguine cérébrale pendant un arrêt circulatoire hypothermique pour les opérations de la crosse aortique. Toutefois, on observe fréquemment une circulation sanguine cérébrale asymétrique accompagnée d'une hypoperfusion de l'hémisphère cérébrale gauche pendant la perfusion cérébrale antérograde sélective. L'objectif de ce compte rendu est de décrire une manoeuvre d'appoint destinée à améliorer la circulation sanguine cérébrale pendant la Electronic supplementary material The online version of this article

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Cerebral oximetry monitoring to maintain NORMal Cerebral Oxygen SATuration (NORMOSAT during high-risk cardiac surgery: a randomized controlled feasibility trial

Cited by 42 publications

References 0 publications

Performance comparison of the MOXY and PortaMon near-infrared spectroscopy muscle oximeters at rest and during exercise

Performance comparison of the MOXY and PortaMon near-infrared spectroscopy muscle oximeters at rest and during exercise

Can we create a Canadian Perioperative Anesthesia Clinical Trials Group? We review the first five years and glimpse into the future

External carotid compression: a novel technique to improve cerebral perfusion during selective antegrade cerebral perfusion for aortic arch surgery

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