Cerebral oxygenation during warming after cardiopulmonary bypass

Sapire, Kenneth; Gopinath, Shankar P.; Farhat, George; Thakar, Dilip; Gabrielli, A.; Jones, James W.; Robertson, Claudia S.; Chance, Britton

doi:10.1097/00003246-199710000-00014

Cited by 79 publications

(67 citation statements)

References 28 publications

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“…Furthermore, poor agreement between the two methods of cerebral oxygenation were detected in head injury patients 18,19 as well as in patients resuscitated from cardiac arrest. 20 Sapire et al 21 found a good correlation (r2=0.63, P <0.001) between the changes from baseline of SjO 2 and regional oxygenation monitored by another NIRS (RunMan, NIM, Philadelphia, PA) device. Yet, correlation was poor in some patients, and in others, there was a delay between the two measurements.…”

Section: Discussionmentioning

confidence: 94%

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Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery

Ali

Harmer

Vaughan

et al. 2001

Can J Anesth/J Can Anesth

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Spatially troscopy does not resolved spec-(NIRO-300) agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery Purpose: Near infrared spectroscopy (NIRS) is a promising noninvasive method for continuous monitoring of cerebral oxygenation during cardiac surgery with cardiopulmonary bypass (CPB). This study was designed to study the agreement between tissue oxygen index (TO o measured by spatially resolved spectroscopy (NIRO-300) and jugular bulb oxygen saturation (SjO2) in patients undergoing warm coronary bypass surgery.Methods: Seventeen patients undergoing warm coronary artery bypass surgery were studied. NIRS was continuously monitored and was averaged before CPB, five, 20, 40, 60 min on CPB, five minutes before end of CPB and ten minutes after CPB to coincide with SjO 2 measurements. Bypass temperature was maintained at 34-37°C.Results: Bland and Altman analysis showed a bias (TOI-SjO2) of-6.7%, and wide limits of agreement (from 16% to -28%) between the two methods. In addition, mean TOI was lower than mean SjO~ during and after CPB. We observed a statistically significant correlation between arterial carbon dioxide and SjO 2 measurements (r 2 0.33; P 0.0003), but the former did not correlate with TOI values (r 2 0.001; P 0.7).Conclusion: Our results demonstrate a lack of agreement between SjO 2 and TOI for monitoring cerebral oxygenation during cardiac surgery. We conclude that the two methods are not interchangeable. Objectif : La spectroscopie proche infrarouge (SPIR) est une m&hode non effractive et prometteuse de monitorage continu de I'oxyg4nation c&4brale utilis& en chirurgie cardiaque sous circulation extracorporelle (CEC). L'&ude actuelle voulait tester la concordance entre I'in

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Section: Discussionmentioning

confidence: 94%

“…Yet, correlation was poor in some patients, and in others, there was a delay between the two measurements. 21 The authors also suggested that this time difference might be a result of the difference between regional oxygenation in the area of the brain monitored by NIRS and the global oxygen saturation measured by jugular bulb catheter.…”

Section: Discussionmentioning

confidence: 99%

Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery

Ali

Harmer

Vaughan

et al. 2001

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

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“…This differs from Sapire et al ., 11 who reported an increase in V-A lactate difference during the rewarming period in hypothermic CPB (15°C-33°C). This increase in V-A lactate difference was related to the decrease of SjvO 2 .…”

Section: Discussionmentioning

confidence: 99%

Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Okano

Owada

Fujita

et al. 2000

Can J Anesth/J Can Anesth

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“…While Kadoi et al 34 found that NIRS was more effective in detecting brain desaturation than SjVO 2 at certain stages of normothermic and hypothermic CABG and suggested that one should not rely solely on SjVO 2 during cardiopulmonary bypass (CPB), others 24,27,48 considered NIRS less sensitive than SjVO 2 . The sole randomized controlled trial 63 performed did not ascertain any difference in the number of neurological complications between patients who underwent NIRS monitoring and those who did not.…”

Section: Clinical Efficacy Of Nirs In Heart Surgerymentioning

confidence: 99%

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

Taillefer

Denault

2005

Can J Anesth/J Can Anesth

131

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P Pu ur rp po os se e: : This systematic review is aimed at answering the following questions: 1) Is near-infrared spectroscopy (NIRS) clinically effective in detecting cerebral desaturation during heart surgery? 2) Are these results based on studies with solid methodology?S So ou ur rc ce es s: : MEDLINE, internet, and hand searches up to February 2004 for English and French papers on NIRS.P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Forty-eight papers were retrieved, with a total of 5,931 cardiac surgery patients monitored by NIRS. More than 83% of patients underwent coronary artery bypass graft surgery. The majority of studies were prospective for the monitored group. Clinically, NIRS monitoring appears to detect brain desaturation episodes encountered during surgery. However, the majority of studies retrieved suffered from major methodological limitations and a low level of evidence. NIRS validity vs jugular bulb oximetry is questioned together with its predictive value in identifying those who will suffer postoperatively from neurological deficits. The sole randomized controlled trial appears to have recorded negative results in this respect.C Co on nc cl lu us si io on n: : The clinical application of NIRS in heart surgery as a brain-monitoring device seems interesting. However, NIRS has to be investigated more rigorously to prove its clinical utility in cardiac surgery. EUROLOGICAL complications and cognitive deficits are preoccupations in cardiac surgery because of their frequency, variety and long-term impact. [1][2][3] Disparities between prevalence and incidence can be explained by patient characteristics (age and comorbidities), 2,4-6 type of surgery, 4 differences in definitions of deficits, and how and when deficits are measured. Objectif

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Cerebral oxygenation during warming after cardiopulmonary bypass

Cited by 79 publications

References 28 publications

Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery

Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery

Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

Cerebral near-infrared spectroscopy in adult heart surgery: systematic review of its clinical efficacy

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