scholarly journals Quantitative analysis of the effect of end-tidal carbon dioxide on regional cerebral oxygen saturation in patients undergoing carotid endarterectomy under general anaesthesia

2017 ◽  
Vol 84 (2) ◽  
pp. 292-300 ◽  
Author(s):  
Seung-Hee Ki ◽  
Jin-Ho Rhim ◽  
Jae-Hong Park ◽  
Young-Jin Han ◽  
Yong-Pil Cho ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Quantitative Analysis ◽  
Oxygen Saturation ◽  
Carotid Endarterectomy ◽  
General Anaesthesia ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation ◽  
End Tidal Carbon Dioxide ◽  
End Tidal

Near-infrared spectroscopy as a possible device for continuous monitoring of arterial carbon dioxide tension during cardiac surgery

Perfusion ◽  
2011 ◽  
Vol 26 (6) ◽  
pp. 524-528 ◽  
Author(s):  
CS Park ◽  
JG Kwak ◽  
C Lee ◽  
C-H Lee ◽  
SK Lee ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Continuous Monitoring ◽  
Near Infrared ◽  
Right Hemisphere ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation

Background: Insufflation of carbon dioxide (CO2) to the operative field has been used to prevent major organ injury attributed to air embolisms in cardiac surgery. However, it may be preferable to avoid hypercapnia induced by CO2 insufflation, owing to its potentially harmful effect. To investigate the effectiveness of near-infrared spectroscopy (NIRS) as a possible method for continuous monitoring of arterial CO2 tension during cardiac surgery, we evaluated the correlation between the change in arterial CO2 tension and the change in regional cerebral oxygen saturation (rScO2) obtained from NIRS in as controlled a condition as possible. Methods: Thirty patients who underwent surgical correction for atrial or ventricular septal defects were enrolled in this study. Patients who had pulmonary hypertension or other intracardiac anomalies were excluded. Anesthetic and cardiopulmonary bypass (CPB) management were conducted according to our standard institutional practice. Data obtained from arterial blood gas analyses and corresponding regional cerebral oxygen saturation (rScO2) recorded from NIRS before and after the insufflations of CO2 during CPB were used for analysis. Results: The change in arterial CO2 tension correlated with the change in rScO2 in the left hemisphere (r = 0.681, p <0.001, y = −1.393 + 0.547x) and right hemisphere (r = 0.690, p <0.001, y = −1.999 + 0.486x). To control the effects of other variables, including hematocrit and temperature, these relationship were not reduced (left hemisphere: r=0.678, p<0.001; right hemisphere: r=0.634, p<0.001). Conclusions: Since the change in regional cerebral oxygen saturation was correlated with the change in arterial CO2 tension during mild hypothermic CPB, NIRS might be a possible non-invasive method for monitoring of arterial CO2 tension without incurring additional cost in this setting.

Effect of carbon dioxide pneumoperitoneum on regional cerebral oxygen saturation during laparoscopic surgery in Trendelemburg position

2006 ◽  
Vol 23 (Supplement 37) ◽  
pp. 25
Author(s):  
P. Doménech ◽  
J. Hernández-Palazón ◽  
L. Sánchez-Ródenas ◽  
F. Pérez-Bautista ◽  
A. Sánchez-Amador ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Oxygen Saturation ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation ◽  
Carbon Dioxide Pneumoperitoneum

Effects of relative low minute ventilation on cerebral haemodynamics in infants undergoing ventricular septal defect repair

2020 ◽  
Vol 30 (2) ◽  
pp. 205-212
Author(s):  
Weizhi Zhang ◽  
Siyuan Xie ◽  
Ding Han ◽  
Jiapeng Huang ◽  
Chuan Ou-Yang ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Oxygen Saturation ◽  
Flow Velocity ◽  
Minute Ventilation ◽  
Resistance Index ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation ◽  
Mean Flow ◽  
Diastolic Flow

AbstractBackground:Ventilation-associated changes in blood carbon dioxide levels are associated with various physiological changes in infants undergoing surgery. Studies on the effects of mechanical ventilation on cerebral haemodynamics especially for infants with CHD are scarce.Aim:This study was done to compare the changes in regional cerebral oxygen saturation and cerebral blood flow velocity when the end-tidal carbon dioxide partial pressure changed during different minute ventilation settings in infants undergoing ventricular septal defect repair.Methods:A total of 67 patients less than 1 year old with ventricular septal defect were enrolled, and 65 patients (age: 6.7 ± 3.4 months, weight: 6.4 ± 1.5 kg) were studied. After anaesthesia induction and endotracheal intubation, the same mechanical ventilation mode (The fraction of inspired oxygen was 50%, and the inspiratory-to-expiratory ratio was 1:1.5.) was adopted. The end-tidal carbon dioxide partial pressure of 30 mmHg (T1), 35 mmHg (T2), 40 mmHg (T3), or 45 mmHg (T4) were obtained, respectively, by adjusting tidal volume and respiratory rate. Minute ventilation per kilogram was calculated by the formula: minute ventilation per kilogram = tidal volume * respiratory rate/kg. Regional cerebral oxygen saturation was monitored by real-time near-infrared spectroscopy. Cerebral blood flow velocity (systolic flow velocity, end-diastolic flow velocity, and mean flow velocity), pulsatility index, and resistance index were measured intermittently by transcranial Doppler. Systolic pressure, diastolic pressure, stroke volume index, and cardiac index were recorded using the pressure recording analytical method.Results:As the end-tidal carbon dioxide partial pressure increased from 30 to 45 mmHg, regional cerebral oxygen saturation increased significantly from 69 ± 5% to 79 ± 4% (p < 0.001). Cerebral blood flow velocity (systolic flow velocity, end-diastolic flow velocity, and mean flow velocity) increased linearly, while pulsatility index and resistance index decreased linearly from T1 (systolic flow velocity, 84 ± 19 cm/second; end-diastolic flow velocity, 14 ± 4 cm/second; mean flow velocity, 36 ± 10 cm/second; pulsatility index, 2.13 ± 0.59; resistance index, 0.84 ± 0.12) to T4 (systolic flow velocity, 113 ± 22 cm/second; end-diastolic flow velocity, 31 ± 6 cm/second; mean flow velocity, 58 ± 11 cm/second; pulsatility index, 1.44 ± 0.34; resistance index, 0.72 ± 0.07) (p < 0.001). There were significant differences in changes of systolic flow velocity, end-diastolic flow velocity, mean flow velocity, pulsatility index, and resistance index as the end-tidal carbon dioxide partial pressure increased from 30 to 45 mmHg between subgroups of infants ≤6 and infants >6 months, while the changes of regional cerebral oxygen saturation between subgroups were not statistically different. Regional cerebral oxygen saturation and cerebral blood flow velocity (systolic flow velocity, end-diastolic flow velocity, and mean flow velocity) were negatively correlated with minute ventilation per kilogram (r = −0.538, r = −0.379, r = −0.504, r = −0.505, p < 0.001). Pulsatility index and resistance index were positively related to minute ventilation per kilogram (r = 0.464, r = 0.439, p < 0.001). The diastolic pressure was significantly reduced from T1 (41 ± 7 mmHg) to T4 (37 ± 6 mmHg) (p < 0.001). There were no significant differences in systolic pressure, stroke volume index, and cardiac index with the change of end-tidal carbon dioxide partial pressure from T1 to T4 (p = 0.063, p = 0.382, p = 0.165, p > 0.05).Conclusion:A relative low minute ventilation strategy increases regional cerebral oxygen saturation and cerebral blood flow, which may improve cerebral oxygenation and brain perfusion in infants undergoing ventricular septal defect repair.

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