[Clinical application of portable near infrared oximetry (HEO-200) to neurosurgical monitoring].
Near infrared spectroscopy (NIRS) have been accepted as a useful modality for non-invasive monitoring of brain oxygenation state. Using a newly developed NIRS apparatus, HEO-200, the authors continuously monitored the changes in the oxygenation state of brain hemoglobin during carotid endarterectomy (CEA) or carotid balloon occlusion tests (BOT) in 21 patients. Somatosensory evoked potentials (SEP), regional cerebral blood flow (rCBF) or transcranial Doppler sonography (TCD) were also employed to compare with the NIRS-responses. In 7 of 21 patients, the carotid artery occlusion caused a continuous deoxygenation of brain hemoglobin as well as a decrease in total hemoglobin. These findings correlated well with temporary neurological deficits and a marked reduction of rCBF in the ipsilateral hemisphere in patients who underwent carotid BOT under local anesthesia. The patients also showed a marked decrease in the N20 amplitude of SEP during CEA under general anesthesia. Restoration of blood flow immediately resolved these findings. The other 14 patients demonstrated no or only transient changes on NIRS as well as on SEP and rCBF study. HEO-200 could non-invasively monitor the relative changes of cerebral oxygenation state with good time resolution, and detect critical ischemia during CEA and carotid BOT.
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
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S
Kuroda
K
K
Houkin
T
T
Kobayashi
H
H
Yasuda
S
S
Ushikoshi
H
H
Saito
H
H
Abe
D000368:Aged; D001921:Brain / Q000378:metabolism*; D002545:Brain Ischemia / Q000175:diagnosis; D002339:Carotid Arteries; D002404:Catheterization; D002560:Cerebrovascular Circulation; D016894:Endarterectomy, Carotid; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D010092:Oximetry; D010101:Oxygen Consumption; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation*
D006454:Hemoglobins