Slow rewarming improves jugular venous oxygen saturation during rewarming

Kawahara, Fuminori; Kikuchi, Yuji; Saito, Shigeru; Goto, Fumio; Fujita, Nao

doi:10.1034/j.1399-6576.2003.00063.x

Cited by 47 publications

(26 citation statements)

References 20 publications

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“…4 A lateral skull radiograph confirmed cannula tip placement cranial to a line extending from the atlanto-occipital joint space and caudal to the lower margin of the orbit, thus insuring the absence of extracranial venous blood contamination. 5 Bilateral oximeter sensors were applied to the subject’s forehead, symmetrically along the midline to avoid the sagittal sinus and as far above the orbital ridge to maximize interrogation of brain as the hairline allowed, and connected to a dual-channel FORE-SIGHT cerebral oximeter. Continuous venous jugular bulb (S jb O 2 ) and cardiac output in liters per minute were monitored with a Vigilance hemodynamic monitor (Edwards LifeScience, Irvine, CA), and finger arterial oxygen saturations with a Nellcor pulse oximeter (Model N595, Coviden, Boulder CO) respectively.…”

Section: Methodsmentioning

confidence: 99%

The Accuracy of a Near-Infrared Spectroscopy Cerebral Oximetry Device and Its Potential Value for Estimating Jugular Venous Oxygen Saturation

Ikeda

MacLeod

Grocott

et al. 2014

Anesthesia &Amp; Analgesia

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Background An intriguing potential clinical use of cerebral oximeter measurements (SctO2) is the ability to noninvasively estimate jugular bulb venous oxygen saturation (SjvO2). Our purpose in this study was to determine the accuracy of the FORE-SIGHT® (CAS Medical Systems; Branford, CT), which is calibrated to a weighted average of 70% (SjvO2) and 30% arterial saturation, for Food and Drug Administration pre-market approval 510 (k) certification by adapting an industry standard protocol, ISO 9919:2005 [www.ISO.org] (used for pulse oximeters) and to evaluate the use of SctO2 and SpO2 measurements to noninvasively estimate jugular venous oxygen saturation (SnvO2). Methods Paired blood gas samples from the radial artery and the jugular venous bulb were collected from 20 healthy volunteers undergoing progressive oxygen desaturation from 100 to 70%. The blood sample pairs were analyzed via co-oximetry and used to calculate the approximate mixed vascular cerebral blood oxygen saturation, or reference SctO2 values (refSctO2), during increasing hypoxia. These reference values were compared to bilateral FORE-SIGHT SctO2 values recorded simultaneously with the blood gas draws to determine its accuracy. Bilateral SctO2 and SpO2 measurements were then used to calculate SnvO2 values which were compared to SjvO2. Results Two hundred forty-six arterial and 253 venous samples from 18 subjects were used in the analysis. The ipsilateral FORE-SIGHT SctO2 values showed a tolerance interval (TI) of [−10.72 10.90] Lin’s concordance correlation coefficient (CCC) with standard error (SE) of 0.83 ± 0.073 with the refSctO2 values calculated using arterial and venous blood gases. The combined data had a CCC of 0. 81 + 0.059 with TI of [−9.22 9.40] with overall bias was 0.09% and amplitude of the root mean square of error after it was corrected with random effects analysis was 2.92%. The bias and variability values between the ipsilateral and the contralateral FORE-SIGHT SctO2 measurements varied from person to person. The SnvO2 calculated from the ipsilateral SctO2 and SpO2 data showed a CCC + SE of 0.79 ± 0.088, TI = [−14.93 15.33], slope of 0.98, Y-Intercept of 1.14%) with SjvO2 values with a bias of 0.20% and an Arms of 4.08%. The SnvO2 values calculated independently from contralateral forehead FORE-SIGHT SctO2 values were not as correlated with the SjvO2 values (contralateral side CCC + SE = 0.72 ± 0.118, TI = [−14.86 15.20], slope of 0.66 and y-intercept of 20.36%). Conclusions The FORE-SIGHT cerebral oximeter was able to estimate oxygen saturation within the tissues of the frontal lobe under conditions of normocapnia and varying degrees of hypoxia (with 95% confidence interval of [−5.60 5.78] with ipsilateral blood ample data). These findings from healthy volunteers also suggest that the use of the calculated SnvO2 derived from SctO2 and SpO2 values may be a reasonable noninvasive method of estimating SjvO2 and therefore global cerebral oxygen consumption in the clinical setting. Further laboratory and clinical research is ...

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Section: Methodsmentioning

confidence: 99%

The Accuracy of a Near-Infrared Spectroscopy Cerebral Oximetry Device and Its Potential Value for Estimating Jugular Venous Oxygen Saturation

Ikeda

MacLeod

Grocott

et al. 2014

Anesthesia &Amp; Analgesia

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“…Slow rewarming has been associated with better neurocognitive function[10] and improvement in SjO2[11] than rapid rewarming in patients’ undergoing coronary artery bypass graft (CABG) surgery.…”

Section: Introductionmentioning

confidence: 99%

Effect of slow versus rapid rewarming on jugular bulb oxygen saturation in adult patients undergoing open heart surgery

et al. 2014

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Background:A debate has appeared in the recent literature about the optimum rewarming strategy (slow vs. rapid) for the best brain function. This study was designed to compare the effect of slow versus rapid rewarming on jugular bulb oxygen saturation (SjO2) in adult patients undergoing open heart surgery.Materials and Methods:A total of 80 patients undergoing valve and adult congenital heart surgery were randomly allocated equally to rapid rewarming group 0.5 (0.136)°C/min and slow rewarming group 0.219 (0.055)°C/min in jugular bulb sampling was taken before, during and after surgery. Surgery was done at cardiopulmonary bypass (CPB) temperature of 28-30°C and rewarming was performed at the end of the surgical procedure.Results:CPB time, rewarming period were significantly longer in the slow rewarming group. Significant difference was observed in the number of the desaturated patients (SjO2 ≤ 50%) between the two groups; 14 (35%) in rapid rewarming versus 6 (15%) in the slow rewarming group; P = 0.035 by Fisher's exact test.Conclusions:Slow rewarming could reduce the incidence of SjO2 desaturation during rewarming in adult patients undergoing open heart surgery.

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“…10 Thus, it was important to consider the change of temperature when we evaluated the reduction in SjO 2 during rewarming period. In the present study, in order to evaluate the effect of milrinone during the rewarming period, we calculated a quotient of ΔSjO 2 /Δt at two measurement points after the start of the rewarming, although the change in temperature during the rewarming period was designed to be comparable between groups.…”

Section: Discussionmentioning

confidence: 99%

Milrinone, a phosphodiesterase III inhibitor, prevents reduction of jugular bulb saturation during rewarming from hypothermic cardiopulmonary bypass

et al. 2011

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Slow rewarming improves jugular venous oxygen saturation during rewarming

Abstract: A slow rewarming rate could reduce the chance of a decrease in SjvO2 during rewarming.

Cited by 47 publications

References 20 publications

The Accuracy of a Near-Infrared Spectroscopy Cerebral Oximetry Device and Its Potential Value for Estimating Jugular Venous Oxygen Saturation

The Accuracy of a Near-Infrared Spectroscopy Cerebral Oximetry Device and Its Potential Value for Estimating Jugular Venous Oxygen Saturation

Effect of slow versus rapid rewarming on jugular bulb oxygen saturation in adult patients undergoing open heart surgery

Milrinone, a phosphodiesterase III inhibitor, prevents reduction of jugular bulb saturation during rewarming from hypothermic cardiopulmonary bypass

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