Cerebral oxygen monitoring during neonatal cardiopulmonary bypass and deep hypothermic circulatory arrest

被引:42
作者
Abdul-Khaliq, H [1 ]
Troitzsch, D [1 ]
Schubert, S [1 ]
Wehsack, A [1 ]
Böttcher, W [1 ]
Gutsch, E [1 ]
Hübler, M [1 ]
Hetzer, R [1 ]
Lange, PE [1 ]
机构
[1] German Heart Inst Berlin, Dept Thorac & Cardiovasc Surg, Dept Congenital Heart Dis & Paediat Cardiol, Berlin, Germany
关键词
cerebral oxygen metabolism; near-infrared spectroscopy; cardio pulmonary bypass; deep hypothermic circulatory arrest; newborn piglets;
D O I
10.1055/s-2002-26698
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: This study was undertaken to investigate the physiological effects of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on cerebral oxygen metabolism estimated by near-infrared spectroscopy (NIRS). Methods: Ten newborn piglets (2.1 to 2.6 kg) were monitored with right frontal NIRS; the right jugular bulb was cannulated for intermittent sampling of jugular venous blood. All animals underwent CPB, cooling to a core temperature below 15degreesC, 60 minutes of DHCA followed by subsequent reperfusion and rewarming. Continuously recorded NIRS data and intermittent jugular venous blood values were compared. Results: NIRS performance was examined over the jugular venous oxygen saturation (SjvO(2)) range of 40 to 98%, a linear correlation was found between SjvO(2) and NIRS-derived regional cerebral oxygen saturation (rDO(2)) (r=0.91, p<0.001). A correlation was observed between the cellular oxidation NIRS-parameter cytochrome oxidase aa3 (CytOx) slope during the DHCA period in relation to rectal and nasopharyngeal temperature immediately before the onset of DHCA (r=0.75 and 0.85, p<0.001). Conclusions: This study suggests that NIRS-measured hemoglobin oxygenation parameters may reflect functional changes in cerebral hemodynamics and brain tissue oxygenation, while CytOx values represent related effects on intracellular oxidative metabolism.
引用
收藏
页码:77 / 81
页数:5
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