title: Evaluation of brain oxygenation during selective cerebral perfusion by near-infrared spectroscopy.
abstract: BACKGROUND
  Although selective cerebral perfusion (SCP) has been used for cerebral protection in aortic arch operations, the appropriate perfusion conditions of SCP are unclear.
  
  
  METHODS
  We used near-infrared spectroscopy, which evaluates brain ischemia noninvasively and continuously, to determine whether perfusion with SCP (core temperature, 20 degrees C; flow rate, 10 mL.kg-1.min-1) was acceptable in terms of oxyhemoglobin and deoxyhemoglobin in patients having SCP for aortic arch operations (SCP group, n = 6) versus patients having cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CPB group, n = 6).
  
  
  RESULTS
  There were no significant differences in age (65 +/- 10 versus 63 +/- 12 years), CPB time (199 +/- 67 versus 199 +/- 52 minutes), changes in hematocrit (-12.9% +/- 3.7% versus -12.5% +/- 6.0%), lowest blood pressure (43 +/- 7 versus 45 +/- 10 mm Hg), or highest central venous pressure (8 +/- 2 versus 9 +/- 4 mm Hg) between the SCP and CPB groups. In the SCP group, the maximum decrease in oxyhemoglobin level and the maximum increase in deoxyhemoglobin level were -5.0 to -11.4 mumol/L and -0.1 to 3.9 mumol/L, respectively; in the CPB group, the respective changes were -3.2 to -14.2 mumol/L and -0.4 to 3.6 mumol/L. Changes of oxyhemoglobin and deoxyhemoglobin levels in the SCP group were almost within the range of those in the CPB group. There were no brain complications in either group.
  
  
  CONCLUSIONS
  As described here, SCP is acceptable and safe for brain protection in aortic arch procedures.
authors.affiliation: First Department of Surgery and Critical Care Medical Center, Yamaguchi University School of Medicine, Ube, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Katoh
authors.forename: K
authors.initials: K
authors.lastname: Esato
authors.forename: H
authors.initials: H
authors.lastname: Gohra
authors.forename: K
authors.initials: K
authors.lastname: Hamano
authors.forename: Y
authors.initials: Y
authors.lastname: Fujimura
authors.forename: N
authors.initials: N
authors.lastname: Zempo
authors.forename: K
authors.initials: K
authors.lastname: Nakashima
authors.forename: T
authors.initials: T
authors.lastname: Maekawa
mesh_terms: D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery; D001794:Blood Pressure; D001921:Brain / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D002560:Cerebrovascular Circulation; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D010108:Oxyhemoglobins / Q000032:analysis*; D019265:Spectroscopy, Near-Infrared
chemical_list: D006454:Hemoglobins; D010108:Oxyhemoglobins; C100003:deoxyhemoglobin