title: The effects of different ventilator modes on cerebral tissue oxygen saturation in patients with bidirectional superior cavopulmonary connection.
abstract: OBJECTIVE
  We used near-infrared spectroscopy to document changes in cerebral tissue oxygen saturation (SctO2) in response to ventilation mode alterations after bidirectional Glenn (BDG; superior cavopulmonary connection) procedure. We also determined whether spontaneous ventilation have a beneficial effect on hemodynamic status, lactate and SctO2 when compared with other ventilation modes.
  
  
  METHODS
  20 consecutive patients undergoing BDG were included. We measured SctO 2 during three ventilator modes (intermittent positive-pressure ventilation [IPPV]; synchronized intermittent mandatory ventilation [SIMV]; and continuous positive airway pressure + pressure support ventilation [CPAP + PSV]). We, also, measured mean airway pressure (AWP), arterial blood gases, lactate and systolic arterial pressures (SAP).
  
  
  RESULTS
  There was no change in SctO2 in IPPV and SIMV modes; the SctO2 measured during CPAP + PSV and after extubation increased significantly (60.5 ± 11, 61 ± 10, 65 ± 10, 66 ± 11 respectively) (P < 0.05). The differences in the SAP measured during IPPV and SIMV modes was insignificant; the SAP increased significantly during CPAP + PSV mode and after extubation compared with IPPV and SIMV (109 ± 11, 110 ± 12, 95 ± 17, 99 ± 13 mmHg, respectively) (P < 0.05). Mean AWP did not change during IPPV and SIMV modes, mean AWP decreased significantly during CPAP + PSV mode (14 ± 4, 14 ± 3, 10 ± 1 mmHg, respectively) (P < 0.01).
  
  
  CONCLUSIONS
  The SctO2 was higher during CPAP + PSV ventilation and after extubation compared to IPPV and SIMV modes of ventilation. The mean AWP was lower during CPAP + PSV ventilation compared to IPPV and SIMV modes of ventilation.
authors.affiliation: Department of Anesthesiology, Baskent University Istanbul Teaching and Medical Research Center, İstanbul, Turkey.
authors.forename: Ayda
authors.initials: A
authors.lastname: Türköz
authors.forename: Şule Turgut
authors.initials: ŞT
authors.lastname: Balcı
authors.forename: Hülya
authors.initials: H
authors.lastname: Gönen
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Çınar
authors.forename: Emre
authors.initials: E
authors.lastname: Özker
authors.forename: Rıza
authors.initials: R
authors.lastname: Türköz
mesh_terms: D000768:Anesthesia, General; D001923:Brain Chemistry / Q000502:physiology*; D002315:Cardiopulmonary Bypass; D003422:Critical Care; D005260:Female; D006801:Humans; D007223:Infant; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology*; D011175:Positive-Pressure Respiration; D012121:Respiration, Artificial / Q000379:methods; D019265:Spectroscopy, Near-Infrared; D014656:Vascular Surgical Procedures; D012122:Ventilators, Mechanical
chemical_list: D010100:Oxygen