[Regional cerebral oxygen saturation as a monitor of cerebral oxygenation and perfusion during deep hypothermic circulatory arrest and selective cerebral perfusion].
In order to evaluate cerebral oxygenation and perfusion during deep hypothermic circulatory arrest (DHCA) and selective cerebral perfusion (SCP), continuous measurement of regional cerebral oxygen saturation (rSO2) by near-infrared spectroscopy (NIRS) was performed. Two patients undergoing aortic arch surgery performed under DHCA and SCP were studied. 1) Circulatory arrest produced a continuous decrease in rSO2. Introduction of SCP increased rSO2 to even above the pre-circulatory arrest level (reperfusion hyperoxia). 2) During SCP, changes in rSO2 correlated well with the naso-pharyngeal temperature, SCP flow rate, and level of carbon-dioxide insufflation to SCP. 3) These changes in rSO2 paralleled with those of jugular venous hemoglobin saturation (SjO2) measured simultaneously, although SjO2 frequently exhibited artifacts. We conclude that rSO2 measurement may be a non-invasive and continuous measure in the evaluation of cerebral oxygenation and perfusion during DHCA and SCP.
Aono
M
M
Department of Anesthesiology, Chiba University School of Medicine.
Sata
J
J
Nishino
T
T
D000328:Adult; D001013:Aorta, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D001921:Brain / Q000378:metabolism*; D002560:Cerebrovascular Circulation; D005112:Extracorporeal Circulation / Q000379:methods; D006324:Heart Arrest, Induced; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010101:Oxygen Consumption