title: [Cerebral oximetry monitoring during bypass surgery: can the approach be changed?].
abstract: We describe the detection of postoperative neurologic complications by means of monitoring cerebral oximetry during cardiac surgery. A 54-year-old man underwent emergency surgery for aortic dissection, type A. Cerebral oximetry was monitored by near-infrared spectroscopy. At the start of total cardiopulmonary bypass through the axillary artery, cerebral oxygen saturation fell more than 50% from baseline in both hemispheres. Saturation did not improve on optimizing factors that influence cerebral blood flow. Improvement came only when the recently inserted arterial cannula was switched to the ascending aortic prosthetic graft. After surgery, the patient was diagnosed with anoxic brain injury. We believe that the detected fall in cerebral oxygen saturation during axillary artery cannulization probably coincided with the occurrence of anoxic brain injury.
authors.affiliation: Servicio de Anestesia y Reanimación, Complejo Hospitalario de Burgos, Madrid. anitafuertes@yahoo.es
authors.forename: A
authors.initials: A
authors.lastname: Fuertes Olivera
authors.forename: R
authors.initials: R
authors.lastname: Martín Celemín
authors.forename: G
authors.initials: G
authors.lastname: Martín Hernández
authors.forename: M
authors.initials: M
authors.lastname: Orts Rodríguez
authors.forename: A
authors.initials: A
authors.lastname: Planas Roca
mesh_terms: D000784:Aortic Dissection / Q000601:surgery; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery; D001366:Axillary Artery; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D002408:Catheters, Indwelling; D002560:Cerebrovascular Circulation; D005112:Extracorporeal Circulation / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010092:Oximetry / Q000379:methods*; D018458:Persistent Vegetative State / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*; D019265:Spectroscopy, Near-Infrared