Assessment of cerebral oxygen balance during deep hypothermic circulatory arrest by continuous jugular bulb venous saturation and near-infrared spectroscopy.
OBJECTIVE
The purpose of this study was to compare jugular venous bulb saturation (SjvO(2)) and regional cerebral oximetry (rSO(2)) by near-infrared spectroscopy (NIRS) during procedures with deep hypothermic circulatory arrest (DHCA).


METHODS
Prospective observational study.


METHODS
Academic hospital.


METHODS
Patients undergoing aortic reconstructive surgery with DHCA from July 2001 to January 2005.


METHODS
The authors examined cerebral oxygenation by continuous NIRS monitoring and by blood gas analysis of intermittently sampled jugular bulb blood (SjvO(2)). Data were obtained during various stages of the procedure in 29 patients. NIRS measurements were compared with SjvO(2).


RESULTS
NIRS and SjvO(2) trends were similar. Overall, cerebral venous oxygen saturation obtained from NIRS was lower compared with SjvO(2) (p < 0.05), especially during periods of low temperature. The mean correlation between NIRS and SjvO(2) was 0.363, and the individual correlations varied from -0.11 to 0.91. The low mean correlation was because of a high degree of variability in the NIRS data between patients.


CONCLUSIONS
It was concluded that NIRS does not closely correlate with SjvO(2) in this patient population. Cerebral oximetry measured by NIRS could not replace jugular bulb saturation as an intraoperative marker of adequate metabolic suppression.
Leyvi
Galina
G
Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA. gleyvi@montefiore.org
Bello
Ricardo
R
Wasnick
John D
JD
Plestis
Konstantinos
K
D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D001784:Blood Gas Analysis / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000379:methods; D002560:Cerebrovascular Circulation / Q000502:physiology*; D050792:Circulatory Arrest, Deep Hypothermia Induced / Q000379:methods*; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007601:Jugular Veins / Q000502:physiology*; D008297:Male; D016343:Monitoring, Intraoperative / Q000295:instrumentation / Q000379:methods*; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood / Q000378:metabolism*; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D013997:Time Factors
D000925:Anticoagulants; D006493:Heparin; D010100:Oxygen