scholarly journals Effective method of monitoring cerebral tissue oxygen saturation in cardiac surgery patients by combined use of tNIRS-1 and bispectral index

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
A. Sugiura ◽  
K. Torii ◽  
H. Tsutsumi ◽  
T. Someya ◽  
D. Yasuoka ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Bispectral Index ◽  
Hemoglobin Concentration ◽  
Tissue Oxygen Saturation ◽  
Cerebral Hypoxia ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Combined Use ◽  
The Relationship

AbstractTo continuously and noninvasively monitor the cerebral tissue oxygen saturation (StO2) and hemoglobin concentration (gasHb) in cardiac surgery patients, a method combining the use of a cerebral tissue oximeter using near infrared time-resolved spectroscopy (tNIRS-1) and the bispectral index (BIS) was developed in this study. Moreover, the correlation between the estimated hemoglobin concentration (estHb), measured via tNIRS-1, and the hemoglobin concentration (gasHb), analyzed using a blood gas analyzer, were compared. The relationship between the BIS and gasHb was also examined. Through the comparison of BIS and StO2 (r1), and estHb and gasHb (r2), the correlation between the two was clarified with maximum r1 and r2 values of 0.617 and 0.946, respectively. The relationship between BIS and gasHb (r3), showed that there was a favorable correlation with a maximum r3 value of 0.969. There was also a continuous correlation between BIS and StO2 in patients undergoing cardiac surgery. In addition, a strong correlation was found between estHb and gasHb, and between BIS and gasHb. It was therefore concluded that the combined use of BIS and tNIRS-1 is useful to evaluate cerebral hypoxia, allowing for quick response to cerebral hypoxia and reduction of hemoglobin concentration during the operation.

scholarly journals Differences Between Central Venous and Cerebral Tissue Oxygen Saturation in Anaesthetised Patients With Diabetes Mellitus

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Roberta Sudy ◽  
Ferenc Petak ◽  
Almos Schranc ◽  
Szilvia Agocs ◽  
Ivett Blaskovics ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Tissue Oxygen Saturation ◽  
Anaesthesia Induction ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Central Venous ◽  
Patients With Diabetes ◽  
And Control

AbstractThe brain has high oxygen extraction, thus the regional cerebral tissue oxygen saturation (rSO2) is lower than the central venous oxygen saturation (ScvO2). We hypothesised that diabetes widens the physiological saturation gap between ScvO2 and rSO2 (gSO2), and the width of this gap may vary during various phases of cardiac surgery. Cardiac surgery patients with (n = 48) and without (n = 91) type 2 diabetes mellitus (T2DM) underwent either off-pump coronary artery bypass (OPCAB) or other cardiac surgery necessitating cardiopulmonary bypass (CPB) were enrolled. rSO2 was measured by near-infrared spectroscopy (NIRS) and ScvO2 was determined simultaneously from central venous blood. rSO2 was registered before and after anaesthesia induction and at different stages of the surgery. ScvO2 did not differ between the T2DM and control patients at any stage of surgery, whereas rSO2 was lower in T2DM patients, compared to the control group before anaesthesia induction (60.4 ± 8.1%[SD] vs. 67.2 ± 7.9%, p<0.05), and this difference was maintained throughout the surgery. After anaesthesia induction, the gSO2 was higher in diabetic patients undergoing CPB (20.2 ± 10.4% vs. 12.4 ± 8.6%, p < 0.05) and OPCAB grafting surgeries (17.0 ± 7.5% vs. 9.5 ± 7.8%, p < 0.05). While gSO2 increased at the beginning of CPB in T2DM and control patients, no significant intraoperative changes were observed during the OPCAB surgery. The wide gap between ScvO2 and rSO2 and their uncoupled relationship in patients with diabetes indicate that disturbances in the cortical oxygen saturation cannot be predicted from the global clinical parameter, the ScvO2. Thus, our findings advocate the monitoring value of NIRS in T2DM.

scholarly journals Near-infrared spectroscopy monitoring tissue oxygen saturation after cardiac surgery

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P239
Author(s):  
R Kopp ◽  
S Rex ◽  
K Dommann ◽  
G Schälte ◽  
G Dohmen ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen

Abstract 276: The Effects of Peep and Blood Pressure on Cerebral Tissue Oxygen Saturation During Hemorrhage in Swine

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Jeff R Gould ◽  
Joshua W Lampe ◽  
Lyra Clark ◽  
George Beck ◽  
Brian C Harvey ◽  
...  
Keyword(s):  
Regression Model ◽  
Oxygen Saturation ◽  
Cerebral Oxygenation ◽  
Cerebral Oxygen Saturation ◽  
Right Atrial ◽  
Tissue Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Cerebral Tissue Oxygen Saturation

Introduction: Positive end-expiratory pressure (PEEP) is used to increase oxygen delivery by preventing end-expiratory alveolar collapse. However, the associated increased intrathoracic pressure can lead to an increase in right atrial pressure, and a decrease in venous return and cardiac output. Near infrared spectroscopy (NIRS) can be used as a non-invasive tool to continuously monitor cerebral tissue oxygen saturation. In this pilot study, we examined the effects of PEEP on cerebral oxygen saturation during a controlled hemorrhage. Methods: Four female, domestic swine (~30 kg), were bled to 3 target levels of mean arterial pressure (MAP; 55, 45, and 35 mm Hg). At each MAP target, 3 levels of PEEP were applied using a mechanical ventilator (5, 10, and 15 cm H 2 O) for ~10 minutes each. Following the reinfusion of shed blood and a recovery period, these interventions were repeated. Measurements included invasive aortic pressure and cerebral oxygen saturation using a commercially available tissue oximeter. A total of 61 epochs were entered into the following regression model: cerebral oxygen saturation = MAP + PEEP + animal number. Each epoch contained data from the last ~2 minutes of each MAP target and PEEP level. Results: The regression model yielded a coefficient of 0.30 for MAP ( P < 0.001) and -0.08 for PEEP ( P = 0.09) and overall, explained 94% of the variance in cerebral oxygenation (adjusted R 2 = 0.94, P < 0.001). While MAP was a stronger predictor in the model, higher PEEP levels appear to result in lower levels of cerebral oxygenation (see figure). Conclusions: Cerebral tissue oxygen saturation declines with lower mean arterial pressures and increased levels of PEEP. NIRS to measure cerebral oxygen saturation may be a useful clinical tool to ensure adequate cerebral oxygenation in patients with hypotension related to hemorrhage, particularly in those patients that require greater than physiologic PEEP to maintain central oxygenation.

Cerebral tissue oxygen saturation is associated with N-terminal probrain natriuretic peptide in preterm infants on their first day of life

2014 ◽  
Vol 104 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Corinna Binder-Heschl ◽  
Berndt Urlesberger ◽  
Martin Koestenberger ◽  
Bernhard Schwaberger ◽  
Georg M. Schmölzer ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Natriuretic Peptide ◽  
Preterm Infants ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Cerebral Tissue Oxygen Saturation
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