Effects of hypothermic and normothermic cardiopulmonary bypass on brain oxygenation

Kikuchi, Yuji; Kawahara, Fuminori; Saito, Shigeru; Morita, Toshihiro; Kunimoto, Fumio; Goto, Fumio; Fujita, Nao

doi:10.1016/s0003-4975(99)00306-9

Cited by 55 publications

(55 citation statements)

References 22 publications

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“…4 They examined postoperative neurophysiological dysfunction after CPB at 28°C, 32°C and 37°C, and found that there was a difference in postoperative cognitive function between normothermic (37°C) and hypothermic (28°C) groups, but not between mild hypothermic (32°C) and hypothermic (28°C) groups. Previously, we examined the effects of normothermia (37°C) and hypothermia (30°C) on SjvO 2 during CPB, 5 which indicates the global balance of cerebral blood flow and the cerebral metabolic rate and is used to estimate the adequacy of flow / metabolism coupling in the brain. In this study we found the difference between two groups in the number of patients whose SjvO 2 value was < 50%.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Okano

Owada

Fujita

et al. 2000

Can J Anesth/J Can Anesth

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Section: Discussionmentioning

confidence: 99%

“…5 However, until now, there has been no comparative study assessing the effect of normothermia and mild hypothermia (32°C) on jugular oxygen saturation (SjvO 2 ) during CPB.…”

Section: Vj)mentioning

confidence: 99%

Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Okano

Owada

Fujita

et al. 2000

Can J Anesth/J Can Anesth

Self Cite

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“…S j o 2 desaturation at the beginning of warm CPB may be due to haemodilution, a decrease in MAP, restoration of a lower prebypass temperature to 37 8C with the onset of CPB and increased embolic load due to aortic manipulation during this period. Recently, Kadoi et al [61] found more frequent periods of S j o 2 desaturation during warm CPB with a temperature . 35 8C (10/15 patients) than during cold CPB (5/15 patients).…”

Section: Specific Applications Of Jugular Bulb Oximetry During Cardiamentioning

confidence: 95%

Jugular bulb oximetry during cardiac surgery

Ali¹,

Harmer²,

Latto

2001

Anaesthesia

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Imbalance between cerebral oxygen supply and demand is thought to play an important role in the development of cerebral injury during cardiac surgery. This article presents an overview of cerebral oxygenation monitored by jugular bulb oximetry during cardiac surgery with cardiopulmonary bypass. The general principles of jugular bulb oximetry including physiology, intermittent and continuous monitoring, technical considerations, limitations and potential complications are discussed. Different applications of jugular bulb oximetry during bypass surgery and the possible therapeutic approaches to impaired cerebral oxygenation are described.

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“…While Kadoi et al 34 found that NIRS was more effective in detecting brain desaturation than SjVO 2 at certain stages of normothermic and hypothermic CABG and suggested that one should not rely solely on SjVO 2 during cardiopulmonary bypass (CPB), others 24,27,48 considered NIRS less sensitive than SjVO 2 . The sole randomized controlled trial 63 performed did not ascertain any difference in the number of neurological complications between patients who underwent NIRS monitoring and those who did not.…”

Section: Clinical Efficacy Of Nirs In Heart Surgerymentioning

confidence: 99%

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

Taillefer

Denault

2005

Can J Anesth/J Can Anesth

130

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P Pu ur rp po os se e: : This systematic review is aimed at answering the following questions: 1) Is near-infrared spectroscopy (NIRS) clinically effective in detecting cerebral desaturation during heart surgery? 2) Are these results based on studies with solid methodology?S So ou ur rc ce es s: : MEDLINE, internet, and hand searches up to February 2004 for English and French papers on NIRS.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Forty-eight papers were retrieved, with a total of 5,931 cardiac surgery patients monitored by NIRS. More than 83% of patients underwent coronary artery bypass graft surgery. The majority of studies were prospective for the monitored group. Clinically, NIRS monitoring appears to detect brain desaturation episodes encountered during surgery. However, the majority of studies retrieved suffered from major methodological limitations and a low level of evidence. NIRS validity vs jugular bulb oximetry is questioned together with its predictive value in identifying those who will suffer postoperatively from neurological deficits. The sole randomized controlled trial appears to have recorded negative results in this respect.C Co on nc cl lu us si io on n: : The clinical application of NIRS in heart surgery as a brain-monitoring device seems interesting. However, NIRS has to be investigated more rigorously to prove its clinical utility in cardiac surgery. EUROLOGICAL complications and cognitive deficits are preoccupations in cardiac surgery because of their frequency, variety and long-term impact. [1][2][3] Disparities between prevalence and incidence can be explained by patient characteristics (age and comorbidities), 2,4-6 type of surgery, 4 differences in definitions of deficits, and how and when deficits are measured. Objectif

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Effects of hypothermic and normothermic cardiopulmonary bypass on brain oxygenation

Cited by 55 publications

References 22 publications

Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Jugular bulb oximetry during cardiac surgery

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

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