Neurophysiological and paraspinal oximetry monitoring to detect spinal cord ischemia in patients during and after descending aortic repair: An international multicenter explorative study

Oostveen, Cheryl N.; Weerwind, Patrick W.; Bergs, Paul; Schmidli, Jürg; Bühlmann, Roman; Schefold, Joerg C.; Eberle, Balthasar; Consiglio, J. A.; Schälte, Gereon; Kotelis, Drosos; Hollands, Angelique; Buhre, W.; Schurink, Geert Willem H.; Jacobs, Michael J.; Mook, Walther N. K. A. van; Mess, Werner H.; Sutedja, Nadia A.

doi:10.1016/j.conctc.2020.100545

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…97 Oostveen et al have studied LLR as a tool to detect delayed spinal cord ischemia during and after descending aorta repair. 98 Some of the novel areas where LLR has been studied to enlighten the neurophysiologic aspects or as a diagnostic marker were based on a small sample size. Large scale studies are still lacking in many of these clinical conditions, thereby rendering it difficult to draw meaningful conclusions or subject them to robust statistical analyses.…”

Section: Discussionmentioning

confidence: 99%

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Long Latency Reflexes in Clinical Neurology: A Systematic Review

Dhar

Kamble

Pal

2022

Can. J. Neurol. Sci.

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Background: Long latency reflexes (LLRs) are impaired in a wide array of clinical conditions. We aimed to illustrate the clinical applications and recent advances of LLR in various neurological disorders from a systematic review of published literature. Methods: We reviewed the literature using appropriately chosen MeSH terms on the database platforms of MEDLINE, Web of Sciences, and Google Scholar for all the articles from 1st January 1975 to 2nd February 2021 using the search terms “long loop reflex”, “long latency reflex” and “C-reflex”. The included articles were analyzed and reported using synthesis without meta-analysis (SWiM) guidelines. Results: Based on our selection criteria, 40 articles were selected for the systematic review. The various diseases included parkinsonian syndromes (11 studies, 217 patients), Huntington’s disease (10 studies, 209 patients), myoclonus of varied etiologies (13 studies, 127 patients) including progressive myoclonic epilepsy (5 studies, 63 patients) and multiple sclerosis (6 studies, 200 patients). Patients with parkinsonian syndromes showed large amplitude LLR II response. Enlarged LLR II was also found in myoclonus of various etiologies. LLR II response was delayed or absent in Huntington’s disease. Delayed LLR II response was present in multiple sclerosis. Among the other diseases, LLR response varied according to the location of cerebellar lesions while the results were equivocal in patients with essential tremor. Conclusions: Abnormal LLR is observed in many neurological disorders. However, larger systematic studies are required in many neurological disorders in order to establish its role in diagnosis and management.

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Section: Discussionmentioning

confidence: 99%

“…97 Oostveen et al have studied LLR as a tool to detect delayed spinal cord ischemia during and after descending aorta repair. 98…”

Section: Discussionmentioning

confidence: 99%

Long Latency Reflexes in Clinical Neurology: A Systematic Review

Dhar

Kamble

Pal

2022

Can. J. Neurol. Sci.

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“…Existing results have been obtained from animal studies [ 219 ] and limited clinical data [ 218 , 220 ]. However, two larger studies comparing NIRS technology with neurophysiological monitoring are currently underway [ 221 , 222 ].…”

Section: Spinal Ischemiamentioning

confidence: 99%

Interdisciplinary German clinical practice guidelines on the management of type B aortic dissection

et al. 2023

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“…Most of the evidence is based on experimental analyses. Despite the lack of validation of this technique in both open and endovascular repair of thoracoabdominal aneurysms, current evidence and guidelines support the perioperative use to monitor spinal oxygenation [1][2][3]5,11 . Similar to the experimental technique MIS²ACE (Minimally-Invasive Staged Segmental Artery Coil-and plug Embolisation), the validity of cnNIRS is currently being investigated as part of the PAPA-ARTiS trial 1 .…”

Section: Introductionmentioning

confidence: 99%

Influence of continuous administration of phenylephine versus dobutamine on paraspinal oxygen saturation

Besard,

Bafort,

Wolfskeil

et al. 2022

Acta Anaest Belg

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Introduction: This randomized controlled trial evaluates the effect of continuous administration of phenylephrine versus dobutamine on paraspinal oxygenation, measured by near-infrared spectroscopy (NIRS). Paraspinal NIRS-monitoring evaluates the spinal oxygenation in an indirect, continuous and real-time manner. The influence of these drugs on the paraspinal oxygenation is unknown, but can be highly relevant during major aortic repair. Methods: This dissertation discusses a preliminary data analysis concerning the first twenty patients included. Phenylephrine or dobutamine were administered continuously during elective arterial dilation procedures of the lower limb. Adhering to a predefined protocol, drug administration was titrated to maintain normotension. The primary outcome variable is the NIRS-measured paraspinal oxygen saturation (rS psO2), this at three distinct paraspinal levels (T3T4 – T9T10 – L1L2), and additionally at the deltoid muscle (rSdO2). A linear mixed modelling approach was used for statistical analysis. This manuscript adheres to the applicable CONSORT guidelines. Results: Estimated mean relative NIRS-values (e.g. changes from baseline) were calculated at the different locations. We observed an overall positive effect on these oximetry values in the dobutamine administered group, this in contrast with an overall negative effect with phenylephrine administration. Significant differences in estimated mean relative values between the groups were observed at the lumbar level (-0.67% vs 2.97%) and at the deltoid muscle (-2.63% vs 2.01%), with significantly higher values during dobutamine administration. Conclusion: By means of a mixed modelling approach to estimate mean relative values of rSpsO2 and rSdO2, we compared the effects of the administration of phenylephrine or dobutamine. Noticeable differences between the two groups were observed and seem to favour the use of dobutamine. Besides an overall positive effect of dobutamine administration, significant differences between the two interventions were observed at the lumbar level, in favour of dobutamine administration. Limitations of this analysis are the rather complex modelling, and the lack of implementation of cardiac output variables in the model.

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Neurophysiological and paraspinal oximetry monitoring to detect spinal cord ischemia in patients during and after descending aortic repair: An international multicenter explorative study

Cited by 10 publications

References 10 publications

Long Latency Reflexes in Clinical Neurology: A Systematic Review

Long Latency Reflexes in Clinical Neurology: A Systematic Review

Interdisciplinary German clinical practice guidelines on the management of type B aortic dissection

Influence of continuous administration of phenylephine versus dobutamine on paraspinal oxygen saturation

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