The role of stump pressure and cerebral oximetry in predicting ischaemic brain damage during carotid endarterectomy

Kuzhuget, R A; Starodubtsev, Vladimir; Ignatenko, Pavel; Starodubtseva, Alexandra; Voroshilina, Olga; Ruzankin, Pavel; Карпенко, А. А.

doi:10.1080/02699052.2017.1347279

Cited by 7 publications

(3 citation statements)

References 18 publications

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“…The level of S100B in TH group was lower compared with the NT group from 6 h after ROSC, while the NSE level was lower in TH group beginning at 24 h after ROSC compared with NT group. These finding were consistent with those of previous studies (19,20). NSE levels have indicated promising results only at later stages (>24 h after cardiac arrest) (21).…”

Section: Discussionsupporting

confidence: 93%

Effects of therapeutic hypothermia on cerebral tissue oxygen saturation in a swine model of post‑cardiac arrest

Jin

et al. 2019

Exp Ther Med

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Since the introduction of therapeutic hypothermia (TH), trends have changed in the monitoring indicators used during and after cardiac arrest. During hypothermia, the cerebral metabolic rate of oxygen is reduced, which leads to uncertainty in regional cerebral tissue oxygen saturation (S ct O 2). The aim of the present study was to evaluate the effect of TH on changes in S ct O 2 using near-infrared spectroscopy. A total of 23 male domestic pigs were randomized into three groups: TH (n=9), normothermia (NT; n=9) and control (n=5). Animals in the control group underwent surgical preparation only. The animal models were established using 8 min of ventricular fibrillation and 5 min of cardiopulmonary resuscitation. In the TH group, at 5 min after resuscitation, the animals were cooled with a cooling blanket and ice packs for 24 h. S ct O 2 was recorded throughout the experiment. In all groups, The mean arterial pressure, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, lactate, neuron-specific enolase (NSE) and S100B were measured at baseline and at 1, 3, 6, 12, 24 and 30 h after resuscitation. S ct O 2 significantly decreased after ventricular fibrillation, compared with the baseline. Following resuscitation, the S ct O 2 values gradually increased to 55.6±3.8% of baseline in the TH group and 51.2±3.5% in the NT group (P=0.039). Significant differences between the two groups were observed, starting at 6 h after cardiac arrest. Throughout the hypothermic period, NSE and S100B showed an increasing trend, then decreased during rewarming in the TH and NT groups. NSE and S100B showed greater improvement in the TH group compared with the NT group at 6 and 24 h after resuscitation. Following cardiac arrest, therapeutic hypothermia could increase S ct O 2 after resuscitation and could improve neurological outcome. In conclusion, S ct O 2 may be a feasible marker for use in the early assessment of brain damage during and after cardiac arrest.

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Section: Discussionsupporting

confidence: 93%

Effects of therapeutic hypothermia on cerebral tissue oxygen saturation in a swine model of post‑cardiac arrest

Jin

et al. 2019

Exp Ther Med

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“…Several studies have found a large increase in S100B levels after declamping [15,16], followed by a reduction in S100B levels 24 hours later [10,17]. Falkensammer [18] investigated the relationship between perioperative levels of the molecular marker S100B and the likelihood of subclinical abnormalities in cerebral function and mild cerebral injury following CEA.…”

Section: Introductionmentioning

confidence: 99%

"Biomarker of Cerebral Injury S100 During Carotid Endarterectomy"

Makovec¹

2022

BJSTR

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Background:The aim of this pilot investigation was to see if a raised serum S100B level or a decrease in rSO 2 following carotid revascularization with CEA might be used to detect neurological instability in CEA patients. Increased serum S100B levels during CEA, we hypothesized, would be linked to neurological symptoms after surgery. Patients and methods: A total of 64 consecutive CEAs in 60 patients operated under LA (local anesthesia) during an 18-month period were prospectively evaluated. The cerebral oximeter was used to measure cerebral oxygen saturation (rSO2) before and after cross-clamping along with serum. concentration of S100B protein. Selective shunting was performed when neurological changes occurred, regardless of NIRS. Results:The neurological symptoms that occurred after clamping correlated with an increase in the serum level of S100B (P = .040). The cut-off of 22.5% of S100B increase was determined to be optimal for identifying patients with neurological symptoms. There was no correlation between rSO 2 decline and neurological symptoms (P = .675). Two (3.1%) perioperative strokes occurred.Conclusions: Awake neuromonitoring has been found to provide a sensitive and direct evaluation of brain tissue perfusion and is specific to CEA under LA. Although there was a favourable connection between CEA and an increase in serum S100B protein, due to the long assessment time, serum S100B monitoring was not practicable (usually 3 hours).

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“…Some studies linked slight cerebral injuies following CEA and a large increase in serum S100B levels [13,14]. Several studies have found a large increase in S100B levels after declamping [15,16], followed by a reduction in S100B levels 24 hours later [10,17]. Falkensammer [18] investigated the relationship between perioperative levels of the molecular marker S100B and the likelihood of subclinical abnormalities in cerebral function and mild cerebral injury following CEA.…”

Section: Introductionmentioning

confidence: 99%