title: Spinal near-infrared spectroscopy measurements during and after thoracoabdominal aortic aneurysm repair: a pilot study.
abstract: BACKGROUND
  Near-infrared spectroscopy (NIRS) is a noninvasive technique that allows continuous monitoring of regional hemoglobin oxygen saturation (rSo2). We evaluated its application to survey oxygenation of the spinal cord region during open thoracoabdominal aortic aneurysm (TAAA) repair and postoperatively in the intensive care unit (ICU). We also validated its association with motor-evoked potential (MEP) monitoring during the operation.
  
  
  METHODS
  The rSo2 curves of 15 patients (8 men; mean age, 64.2 ± 7.7 years) were measured continuously with NIRS at spinal cord levels of the thoracic vertebrae T3 (optode 1, reference spot) and T12 (optode 2) during open TAAA repair. T12/T3 ratios were calculated. NIRS measurements were continued in the intensive care unit and stopped 24 hours after the operation. MEP monitoring was performed in all patients during the procedure.
  
  
  RESULTS
  No clinical signs of spinal cord ischemia were documented in any of the patients. Continuous NIRS measurements were successfully performed in all patients during and after the operation. T12/T3 ratios were significantly lower in the MEP ratios that were less than 50% compared with the MEP ratios that were 50% or higher (p = 0.037).
  
  
  CONCLUSIONS
  NIRS is an easily applicable noninvasive tool for continuous surveillance of oxygenation of the spinal cord region during TAAA repair and postoperatively in the intensive care unit. The rSo2 curves provide useful information concerning hemodynamic changes in oxygenation of the spinal cord region and might contribute to early detection of spinal cord ischemia. Further investigation is needed before broad clinical implementation.
authors.affiliation: Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands. Electronic address: r.boezeman@antoniusziekenhuis.nl.
authors.forename: Reinout P E
authors.initials: RP
authors.lastname: Boezeman
authors.affiliation: Department of Anesthesiology and Intensive Care, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Eric P
authors.initials: EP
authors.lastname: van Dongen
authors.affiliation: Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Morshuis
authors.affiliation: Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Uday
authors.initials: U
authors.lastname: Sonker
authors.affiliation: Department of Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Eduard H J F
authors.initials: EH
authors.lastname: Boezeman
authors.affiliation: Department of Perfusion, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Frans G J
authors.initials: FG
authors.lastname: Waanders
authors.affiliation: Department of Vascular Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors.forename: Jean-Paul P M
authors.initials: JP
authors.lastname: de Vries
mesh_terms: D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D019054:Evoked Potentials, Motor; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D009426:Netherlands; D010100:Oxygen / Q000097:blood*; D061214:Patient Safety; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D020760:Spinal Cord Ischemia / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014463:Ultrasonography; D014656:Vascular Surgical Procedures / Q000009:adverse effects* / Q000379:methods
chemical_list: D010100:Oxygen