Noninvasive Control of Adequate Cerebral Oxygenation During Low-Flow Antegrade Selective Cerebral Perfusion on Adults and Infants in the Aortic Arch Surgery

Rubio, Álvaro Pérez; Hakami, L.; Münch, Frank; Tandler, R.; Harig, Frank; Weyand, Michael

doi:10.1111/j.1540-8191.2008.00644.x

Cited by 34 publications

(21 citation statements)

References 14 publications

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“…The use of ultrasonography and near-infrared spectroscopy to visualize blood flow and assess cerebral oxygenation may assist with these decisions in the future. 38,39 When signs of life and vital signs are absent (stage HT IV), there is consensus that treatment with ECMO or cardiopulmonary bypass is safe and efficient. 1,2,6-8,12,22,24,33,34,40-42 Among patients treated with ECMO or cardiopulmonary bypass, the rate of survival without neurologic impairment is 47 to 63%.…”

Section: R E Scue C Ol L a Pse A Nd A F Ter Dropmentioning

confidence: 99%

Accidental Hypothermia

et al. 2012

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A ccidental hypothermia (i.e., an involuntary drop in core body temperature to <35°C [95°F]) is a condition associated with significant morbidity and mortality. 1-4 Each year, approximately 1500 patients in the United States have hypothermia noted on their death certificate; however, the incidence of primary and secondary hypothermia and the associated morbidity and mortality remain unknown. 5 In a single tertiary care center, 14 different rewarming methods were used to treat 84 cases of accidental hypothermia, 3 which reflects the uncertainties about treatment and the potential for complications. 3 Certain treatment approaches are available only in specialized centers, and clarification is needed regarding the choice between transporting a patient to a specialized center and providing treatment locally. Existing recommendations do not include recent developments in rewarming methods nor do they assist with decisions regarding transportation. 6-8 PR E SEN TAT IONWith cold exposure, the initial response of the body is to maintain a normal core temperature (approximately 37°C [99°F]) by means of active movement and involuntary shivering. Primary hypothermia occurs when heat production in an otherwise healthy person is overcome by the stress of excessive cold, especially when the energy stores of the body are depleted. Secondary hypothermia can occur in ill persons with a wide variety of medical conditions (Table 1), even in a warm environment. Death in patients with secondary hypothermia is often caused by the underlying condition rather than by hypothermia. In all types of hypothermia, consciousness, breathing, and circulation are initially intact but are impaired as the body cools. 10

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Section: R E Scue C Ol L a Pse A Nd A F Ter Dropmentioning

confidence: 99%

Accidental Hypothermia

et al. 2012

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“…Bu teknikte sol hemisfere serebral perfüzyonun yeterliliği Willis halkasının anastamozlarından dolayı sorun oluşturabilir. Selektif serebral perfüzyonda cerrahi sırasında her iki hemisferde yeterli akımın varlığını saptamak ve etkin perfüzyonun monitorizasyonu için standart bir teknik yoktur (7,8) . sırasında TCD ile belirlenen kan akım hızı serebral oksijen satürasyon verilerine değerli bilgiler ekleyerek rehber rol oynamaktadır (9) .…”

Section: Discussionunclassified

“…Buna rağ-men, henüz beyin hasarı için kesin eşik değeri veya anormal değer bilinmemektedir. Hipotermi, düşük akımlı perfüzyon, hatta sirkülatuar arest sırasında kullanılabilir çünkü nabız, basınç ya da ısı bağımlı değildir (7) .…”

Section: Discussionunclassified

Triple Cerebral Monitorization in a Highly Risky Arcus Aorta Aneurysm Repair

Yiğit¹,

Karadeniz²,

Erdemli³

et al. 2012

GKDA Derg

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“…The cerebral rSO2 of adults varies over a wide range from 45% to 85%. 12 It is thought that the cerebral rSO2 values for children are similar to those of adults, 28 and that lower values are not associated with neurological sequelae, 16 particularly for cyanotic congenital heart disease. However, it is difficult to determine ischemia and other such changes based on the absolute cerebral rSO2 value.…”

Section: Discussionmentioning

confidence: 99%

Changes in Cerebral Oxygen Saturation and Blood Flow During Hypoxic Gas Ventilation Therapy in HLHS and CoA/IAA Complex With Markedly Increased Pulmonary Blood Flow

Toiyama

Hamaoka

Oka

et al. 2010

Circ J

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Background: Hypoxic gas ventilation therapy has recently been performed to prevent post-birth increased pulmonary blood flow in cases of congenital heart diseases with increased pulmonary blood flow. However, how the oxygen supply to the tissues changes during breathing a hypoxic gas mixture, remains unknown. The changes in cerebral oxygen saturation and blood supply during hypoxic gas ventilation therapy using a nitrogen gas mixture were studied. Methods and Results:Cerebral regional oxygen saturation (cerebral rSO2) was measured by near-infrared spectroscopy, and changes in middle cerebral artery (MCA) blood flow and an index of vascular resistance (RI) were assessed in 8 consecutive patients having congenital heart diseases with increased pulmonary blood flow. In all patients, urinary volume increased significantly, and the respiratory rate showed a clear decrease. Percutaneous oxygen saturation showed no significant change. The average of cerebral rSO2 was 67.3% before hypoxic gas ventilation, but increased to 69.4%, 69.1%, and 70.7% within 1, 12, and 24 h after initiation of treatment, respectively. MCA blood flow significantly increased in the diastolic phase, and RI significantly improved from 0.80 to 0.68 within 12 h after initiation of therapy. Conclusions:These results indicate that hypoxic gas ventilation therapy does not decrease cerebral oxygen saturation, but safely improves the cerebral blood supply in cases of congenital heart diseases with increased pulmonary blood flow. (Circ J 2010; 74: 2125 - 2131

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Noninvasive Control of Adequate Cerebral Oxygenation During Low-Flow Antegrade Selective Cerebral Perfusion on Adults and Infants in the Aortic Arch Surgery

Abstract: Continuous monitorization of the cerebral O(2) saturation during aortic arch surgery in adults and infants is a feasible technique to control an adequate cannula positioning and to optimize clinical outcomes avoiding neurological complications related to cerebral malperfusion.

Cited by 34 publications

References 14 publications

Accidental Hypothermia

Accidental Hypothermia

Triple Cerebral Monitorization in a Highly Risky Arcus Aorta Aneurysm Repair

Changes in Cerebral Oxygen Saturation and Blood Flow During Hypoxic Gas Ventilation Therapy in HLHS and CoA/IAA Complex With Markedly Increased Pulmonary Blood Flow

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