Oxygenation and hemodynamics in left and right cerebral hemispheres during induction of veno-arterial extracorporeal membrane oxygenation

Heijst, Arno van; Liem, Djien; Hopman, J.C.W.; Staak, Frans van der; Sengers, R. C. A.

doi:10.1016/j.jpeds.2003.11.006

Cited by 50 publications

(39 citation statements)

References 32 publications

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“…In doing this, we hoped to identify any transient decrease in cerebral saturations with the ligation of the carotid artery and/or the internal jugular vein. As the number of subjects studied in the earlier studies [1][2][3][4] was small, our data will further verify or refute the past findings. In addition, we hoped to show improvement in cerebral oxygenation with the commencement of ECMO.…”

Section: Introductionsupporting

confidence: 75%

“…Both Ejike et al 1 and Van Heijst et al 4 observed a decrease of cerebral oxygenation primarily due to right carotid cannulation but not right internal jugular vein cannulation. 3,4 Because carotid and internal jugular cannulation were performed about the same time, we did not distinctly see that SctO 2 's were primarily caused by carotid cannulation. One possible explanation of the observation of decreased cerebral oxygenation following cannulation includes restricted circulatory flow caused by the cannulae.…”

Section: Discussionmentioning

confidence: 95%

“…We did not use a left forehead sensor. On the other hand, Van Heijst et al 4 observed bilateral decrease in cerebral oxygenation following right carotid cannulation in 10 subjects. Procedural differences in technique may explain these findings.…”

Section: Discussionmentioning

confidence: 97%

“…Earlier studies using NIRS to monitor ECMO subjects also observed cerebral oxygenation decreases during ECMO surgery. [1][2][3][4] Ejike et al 1 reported that only the right cerebral hemisphere experienced SctO 2 following right carotid cannulation in three subjects using a bilateral sensor NIRS system. In our study, the cerebral oximetry sensor was placed on the right forehead.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] During this time, the carotid artery and/or the internal jugular vein are ligated to allow for ECMO support, but the procedure may temporarily impair cerebral perfusion. However, the data collected from the cerebral oximetry monitors used in these past studies were not validated and/or provided only trending cerebral oxygenation information.…”

Section: Introductionmentioning

confidence: 99%

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Neonatal cerebral oximetry monitoring during ECMO cannulation

Fenik

Rais-Bahrami

2009

J Perinatol

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Objective: Neonates were monitored with a cerebral oximeter before, during, and after cannulation for ECMO to determine the direct effects of ligation of the right internal jugular vein and right carotid artery on cerebral oxygenation.Study Design: After obtaining informed consent, we used the FORE-SIGHT Cerebral Oximeter (CAS Medical Systems, Branford, CT, USA) to monitor neonates undergoing surgical preparation for veno-arterial (VA) or veno-venous (VV) extracorporeal membrane oxygenation (ECMO).Result: A total of 17 subjects were monitored pre-ECMO for atleast 48 h after cannulation. Of the 17 subjects, 12 experienced low cerebral tissue oxygen saturation (SctO 2 ) <60% during pre-ECMO surgery, with most exhibiting the lowest SctO 2 values between cannulation to the onset of ECMO. Two subjects received cardiopulmonary resuscitation (CPR) during surgery and experienced very low SctO 2 (5 and 36%). Pulse oximetry was found to be unreliable during CPR because of diminished pulsatile flow. SctO 2 increased above 60% after the onset of ECMO for all subjects and remained stable. Conclusion:Neonates are vulnerable to SctO 2 during the pre-ECMO surgical period.

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Section: Introductionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Neonatal cerebral oximetry monitoring during ECMO cannulation

Fenik

Rais-Bahrami

2009

J Perinatol

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Cerebral and Peripheral Tissue Oxygenation in Children Supported on ECMO for Cardio-Respiratory Failure

Papademetriou

Tachtsidis

Leung

et al. 2009

Advances in Experimental Medicine and Biology

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Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with cardio-respiratory failure. Establishing, maintaining and weaning from ECMO may increase the risk for intracranial injury. We used a dual channel near infrared system to monitor cerebral and peripheral tissue oxygenation in 3 venoarterial (VA) and 1 venovenous (VV) ECMO patients undergoing manipulations in the ECMO circuit flows. Spectral analysis was performed on the oxyhaemoglobin data collected from these patients with the aim of comparing oscillations at range of frequencies appearing in the two measurement sites.

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Optical Topography to Measure Variations in Regional Cerebral Oxygenation in an Infant Supported on Veno-Arterial Extra-Corporeal Membrane Oxygenation

Papademetriou

Tachtsidis

Banaji

et al. 2011

Oxygen Transport to Tissue XXXIII

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Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with cardio-respiratory failure which exposes the patient to the risk for intracranial injury. We used a 12-channel optical topography system to monitor cerebral oxygenation in a venoarterial (VA) ECMO patient during alterations in the ECMO flows. Changes in oxy-(HbO2), deoxy-(HHb) and total-(HbT) haemoglobin concentrations were measured simultaneously with systemic and ECMO circuit parameters. Decreasing the flows resulted in a decrease in venous (SvO2) and arterial (SpO2) saturations. These were reflected in the haemoglobin data by a significant increase in HHb of varying magnitude across the 12 channels and moderate changes in HbO2 suggestive of cerebral arterial dilation to compensate for the lack of oxygen delivery. In the patient studied here ECMO flows appear to present a significant haemodynamic challenge to cerebral circulation.

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Oxygenation and hemodynamics in left and right cerebral hemispheres during induction of veno-arterial extracorporeal membrane oxygenation

Cited by 50 publications

References 32 publications

Neonatal cerebral oximetry monitoring during ECMO cannulation

Neonatal cerebral oximetry monitoring during ECMO cannulation

Cerebral and Peripheral Tissue Oxygenation in Children Supported on ECMO for Cardio-Respiratory Failure

Optical Topography to Measure Variations in Regional Cerebral Oxygenation in an Infant Supported on Veno-Arterial Extra-Corporeal Membrane Oxygenation

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