Rapid Diagnosis of Cannula Migration by Cerebral Oximetry in Neonatal Arch Repair

Continuous cerebral hemodynamic measurement during deep hypothermic circulatory arrest

“…The neonatal surgical field, in particular, has extreme space constraints, and the head is often covered with ice for cooling and is generally under a surgical drape, limiting access. Commercial cerebral oximeters based on near-infrared spectroscopy (NIRS) are useful as trend monitors and to ascertain optimal cannula positioning [6,7]. These commercial devices, however, can exhibit considerable inter-device variation [8], and hypothermia may exacerbate inaccuracies due to changes in tissue optical scattering, a parameter which these oximeters generally do not measure.…”

Neuromonitoring in der Kardioanästhesie

“…In zahlreichen Kasuistiken konnte gezeigt werden, dass Minderperfusionen des Gehirns durch Fehllage der aortalen bzw. der Kanüle für die selektive Hirnperfusion durch einen Abfall der regionalen zerebralen rSO 2 im NIRS bemerkt und korrigiert wurden [85][86][87]. Bleibt jedoch ein regionaler zerebraler rSO 2 -Abfall aus, so kann nicht mit Sicherheit auf eine korrekte Kanülenplatzierung und eine ausreichende globale zerebrale Perfusion geschlossen werden.…”

Near Infrared Spectroscopy (NIRS) in Children

“…The cannula was pulled back and repositioned into the proximal arch, which resulted in an immediate improvement in the cerebral oxygen saturation. 51 Similarly, in another case of a child that was undergoing repair of a vascular ring, a significant reduction of the left-sided cerebral saturations was encountered during left common carotid artery clamping despite no change in saturation of the contralateral hemisphere. This unilateral hypoperfusion was attributed to abnormal flow through the circle of Willis, which has been described in up to 10% of healthy infants.…”