Near infrared spectrophotometry reflects cerebral metabolism during hypothermic circulatory arrest in adults

Citation
T. Kunihara et al., Near infrared spectrophotometry reflects cerebral metabolism during hypothermic circulatory arrest in adults, ASAIO J, 47(4), 2001, pp. 417-421
Citations number
27
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Research/Laboratory Medicine & Medical Tecnology
Journal title
ASAIO JOURNAL
ISSN journal
1058-2916 → ACNP
Volume
47
Issue
4
Year of publication
2001
Pages
417 - 421
Database
ISI
SICI code
1058-2916(200107/08)47:4<417:NISRCM>2.0.ZU;2-P
Abstract
Near-infrared spectrophotometry (NIRS) is assumed to reflect cerebral oxyge nation during hypothermic circulatory arrest (HCA). However, the rationale for the use of NIRS as a marker of cerebral metabolism remains to be elucid ated. We examined whether cerebral oxygenation measured by NIRS correlated with cerebral metabolic function assessed by cerebral oxygen extraction rat io (OER) during HCA in adults. NIRS was continuously monitored in 14 patien ts undergoing thoracic aortic surgery using HCA (17.9 +/- 2.9 degreesC esop hageal temperature at HCA onset). jugular venous oxygen saturation and OER were also monitored. OER was significantly reduced from 37.3 +/- 7.2% at th e onset of cardiopulmonary bypass to 13.6 +/- 6.2% at the onset of HCA (p < 0.0001). A linear decrease in oxygenated-hemoglobin (oxy-Hb) and increase in deoxygenated-hemoglobin (deoxy-Hb) were found during HCA, which returned to baseline levels after rewarming. The rate of decrease in oxy-Hb and inc rease in deoxy-Hb were -0.63 +/- 0.45 and 0.51 +/- 0.30 (10(-5) OD/cm per s ec), respectively, both of which significantly correlated with OER at the o nset of HCA (R-2 = 0.739 and 0.633; p < 0.0001 and p = 0.0007, respectively ). NIRS may serve as a reliable diagnostic modality for monitoring cerebral metabolism during aortic surgery using HCA.