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Cerebral oximetry

Shinya Terada, Masaki Tabuchi, Akihiko Yamauchi
A 52-years-old man, who had undergone coil embolization of saccular aneurysm of the brachiocephalic artery, presented with right back discomfort. Diagnosis by computed tomography was difficult because of an artifact from the coils. Angiography, on the other hand, revealed a rupture of the aneurysm, and emergency surgery was performed. A Y-shaped graft was anastomosed to the ascending aorta under partial clamp. Then, one of its branches was anastomosed to the common carotid artery also under partial clamp in an end-to-side fashion...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jeffrey E Keenan, Ehsan Benrashid, Emily Kale, Alina Nicoara, Aatif M Husain, G Chad Hughes
Circulatory management during replacement of the aortic arch is complex and involves a period of circulatory arrest to provide a bloodless field during arch vessel anastomosis. To guard against ischemic brain injury, tissue metabolic demand is reduced by systemically cooling the patient prior to circulatory arrest. Neurophysiological intraoperative monitoring (NIOM) is often used during the course of these procedures to provide contemporaneous assessment of brain status to help direct circulatory management decisions and detect brain ischemia...
October 4, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
September 24, 2016: Revista Brasileira de Anestesiologia
Niranjan D Waje, Madan M Maddali, Nilay Chatterjee
No abstract text is available yet for this article.
September 21, 2016: Journal of Neurosurgical Anesthesiology
Jean-Luc Fellahi, Philippe Portran
No abstract text is available yet for this article.
October 2016: Anesthesiology
T Pincez, L Calamy, Z Germont, A Lemoine, A-A Lopes, A Massiot, J Tencer, C Thivent, A Hadchouel
Acute and chronic pulmonary complications are frequent in sickle cell disease (SCD), with different spectrum and characteristics in children and adults. Chronic hypoxia is frequent and plays a role in several respiratory complications in SCD. Furthermore, hypoxia has been associated with a higher risk of cerebral ischemia. Despite differing oxygen affinity between hemoglobin A and S, standard pulse oximetry was shown to be accurate in diagnosing hypoxia in SCD patients. Whereas acute hypoxia management is similar to non-SCD patients, chronic hypoxia treatment is mainly based on a transfusion program rather than long-term oxygen therapy...
October 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Jonatan Myrup Staalsø, Kim Zillo Rokamp, Niels D Olesen, Lars Lonn, Niels H Secher, Niels V Olsen, Teit Mantoni, Ulf Helgstrand, Henning B Nielsen
BACKGROUND: Gly16arg polymorphism of the adrenergic β2-receptor is associated with the elevated cardiac output (Q) in healthy gly16-homozygotic subjects. We questioned whether this polymorphism also affects Q and regional cerebral oxygen saturation (SCO2) during anesthesia in vascular surgical patients. METHODS: One hundred sixty-eight patients (age 71 ± 6 years) admitted for elective surgery were included. Cardiovascular variables were determined before and during anesthesia by intravascular pulse contour analysis (Nexfin) and SCO2 by cerebral oximetry (INVOS 5100C)...
September 13, 2016: Anesthesia and Analgesia
Wojciech Weigl, Daniel Milej, Dariusz Janusek, Stanisław Wojtkiewicz, Piotr Sawosz, Michał Kacprzak, Anna Gerega, Roman Maniewski, Adam Liebert
We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following search terms: "traumatic brain injury," "head injury," or "head trauma," and "optical methods," "NIRS," "near-infrared spectroscopy," "cerebral oxygenation," or "cerebral oximetry." Original reports concerning human subjects published from January 1980 to June 2015 in English were analyzed. Fifty-four studies met our inclusion criteria...
September 7, 2016: Journal of Cerebral Blood Flow and Metabolism
Charles D Deakin, Jie Yang, Robert Nguyen, Jiawen Zhu, Stephen J Brett, Jerry P Nolan, Gavin D Perkins, David G Pogson, Sam Parnia
BACKGROUND: Epinephrine has been presumed to improve cerebral oxygen delivery during cardiopulmonary resuscitation (CPR), but animal and registry studies suggest that epinephrine-induced capillary vasoconstriction may decrease cerebral capillary blood flow and worsen neurological outcome. The effect of epinephrine on cerebral oxygenation (rSO2) during CPR has not been documented in the clinical setting. METHODS: rSO2 was measured continuously using cerebral oximetry in patients with in-hospital cardiac arrest...
August 31, 2016: Resuscitation
S Kleiser, N Nasseri, B Andresen, G Greisen, M Wolf
The SafeBoosC trial showed that cerebral oximetry combined with a treatment guideline can reduce the the burden of hypoxia in neonates by 50% [Brit. Med. J.350, g7635 (2015)]. However, guidelines based on oximetry by one oximeter are not directly usable by other oximeters. We made a blood-lipid phantom simulating the neonatal head to determine the relation between oxygenation values obtained by different oximeters. We calculated coefficients for easy conversion from one oximeter to the other. We additionally determined the corresponding SafeBoosC intervention thresholds at which we measured an uncertainty of up to 9...
August 1, 2016: Biomedical Optics Express
John Weaver, Scott R Burks, Ke Jian Liu, Joseph P Y Kao, Gerald M Rosen
Variations in brain oxygen (O2) concentration can have profound effects on brain physiology. Thus, the ability to quantitate local O2 concentrations noninvasively in vivo could significantly enhance understanding of several brain pathologies. However, quantitative O2 mapping in the brain has proven difficult. The electron paramagnetic resonance (EPR) spectra of nitroxides are sensitive to molecular O2 and can be used to estimate O2 concentrations in aqueous media. We recently synthesized labile-ester-containing nitroxides, such as 3-acetoxymethoxycarbonyl-2,2,5,5-tetramethyl-1-pyrrolidinyloxyl (nitroxide 4), which accumulate in cerebral tissue after in situ hydrolysis, and thus enable spatial mapping of O2 concentrations in the mouse brain by EPR imaging...
October 2016: Journal of Magnetic Resonance
Sarah Soh, Jae-Kwang Shim, Jong-Wook Song, Keung-Nyun Kim, Hyun-Young Noh, Young-Lan Kwak
BACKGROUND: Perioperative cerebral hypoperfusion/ischemia is a major inciting factor of postoperative delirium, which is coupled with adverse outcome in elderly patients. Cerebral oximetry enables noninvasive assessment of the regional cerebral oxygen saturation (rSO2). This study aimed to investigate whether perioperative rSO2 variations were linked to delirium in elderly patients after spinal surgery. MATERIALS AND METHODS: Postoperative delirium was assessed for 48 hours postsurgery in 109 patients aged over 60 years without a prior history of cerebrovascular or psychiatric diseases by the Confusion Assessment Method for the intensive care unit and the intensive care delirium screening checklist...
August 25, 2016: Journal of Neurosurgical Anesthesiology
Z A Vesoulis, C E Lust, S M Liao, S B Trivedi, A M Mathur
OBJECTIVE: Fractional tissue oxygen extraction (FTOE) is a measure derived from cerebral near-infrared spectroscopy (NIRS) and simultaneous pulse oximetry (SpO2), capturing the proportion of oxygen delivered in arterial blood that is used by the target tissue. FTOE may provide a better proxy measurement of retinal hyperoxia than pulse oximetry alone and could provide insight into the risk for retinopathy of prematurity (ROP). In this study, we directly compared hyperoxia burden calculated from FTOE with hyperoxia burden calculated from SpO2 alone in order to assess the strength of association between hyperoxia and severe ROP...
August 25, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Hsin-I Tsai, Peter Chi-Ho Chung, Chao-Wei Lee, Huang-Ping Yu
INTRODUCTION: The technology near infrared spectroscopy (NIRS) has been utilized extensively in several clinical settings and one of which is in cerebral oximetry. This review will provide information on the technology, clinical applications and algorithm to follow when desaturation occurs. AREAS COVERED: The review will cover the technology of near infrared spectroscopy, cerebral oximetry and the utilization of cerebral oximetry in each clinical setting. Expert commentary: Cerebral oximetry provides a noninvasive measure of cerebral oxygenation, which when persistently declining, can serve as a warning sign of hemodynamic or metabolic compromise intraoperatively or a predictor of postoperative cognitive dysfunction...
September 2016: Expert Review of Medical Devices
Aggrey Dhabangi, Brenda Ainomugisha, Christine Cserti-Gazdewich, Henry Ddungu, Dorothy Kyeyune, Ezra Musisi, Robert Opoka, Christopher P Stowell, Walter H Dzik
Importance: Severe anemia, defined as a hemoglobin level of less than 5.0 g/dL, affects millions of children worldwide. The brain has a high basal demand for oxygen and is especially vulnerable to hypoxemia. Previous studies have documented neurocognitive impairment in children with severe anemia. Data on cerebral tissue oxygenation in children with severe anemia and their response to blood transfusion are limited. Objective: To measure hemoglobin saturation in cerebral tissue (cerebral tissue oxygen saturation [tSo2]) before, during, and after blood transfusion in a cohort of children presenting to hospital with severe anemia...
October 1, 2016: JAMA Pediatrics
Aymen N Naguib, Peter D Winch, Roby Sebastian, Daniel Gomez, Luisa Guzman, Julie Rice, Dmitry Tumin, Mark Galantowicz, Joseph D Tobias
BACKGROUND: Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional cerebral oxygen saturation (rSO2). OBJECTIVES: The primary aim was to compare the output of 2 NIRS-based cerebral oximetry devices, FORESIGHT (CAS Medical Systems Inc, Branford, Connecticut) and INVOS (Covidien, Boulder, Colorado), to venous oxygen saturations from the jugular venous bulb at cannulation and decannulation of the superior vena cava (SVC). Secondary objectives included evaluating correlations of cerebral saturation, as measured by the NIRS devices, with mean arterial blood pressure (MAP), measured by an invasive arterial line, and end-tidal CO2 (ETCO2)...
August 15, 2016: Journal of Intensive Care Medicine
Philip E Bickler, John R Feiner, Michael S Lipnick, Paul Batchelder, David B MacLeod, John W Severinghaus
Extended periods of oxygen deprivation can produce acidosis, inflammation, energy failure, cell stress, or cell death. However, brief profound hypoxia (here defined as SaO2 50%-70% for approximately 10 minutes) is not associated with cardiovascular compromise and is tolerated by healthy humans without apparent ill effects. In contrast, chronic hypoxia induces a suite of adaptations and stresses that can result in either increased tolerance of hypoxia or disease, as in adaptation to altitude or in the syndrome of chronic mountain sickness...
August 12, 2016: Anesthesia and Analgesia
André Rüffer, Philip Tischer, Frank Münch, Ariawan Purbojo, Okan Toka, Wolfgang Rascher, Robert Anton Cesnjevar, Jörg Jüngert
BACKGROUND: Cerebral protection during aortic arch repair can be provided by regional cerebral perfusion (RCP) through the innominate artery. This study addresses the question of an adequate bilateral blood flow in both hemispheres during RCP. METHODS: Fourteen infants (median age 11 days [range, 3 to 108]; median weight, 3.6 kg [range, 2.8 to 6.0 kg]) undergoing RCP (flow rate 54 to 60 mL · kg(-1) · min(-1)) were prospectively included. Using combined transfontanellar/transtemporal two- and three-dimensional power/color Doppler sonography, cerebral blood flow intensity in the main cerebral vessels was displayed...
August 12, 2016: Annals of Thoracic Surgery
Nancy S Ghanayem, George M Hoffman
OBJECTIVES: The objectives of this review are to discuss the technology and clinical interpretation of near infrared spectroscopy oximetry and its clinical application in patients with congenital heart disease. DATA SOURCE: MEDLINE and PubMed. CONCLUSION: Near infrared spectroscopy provides a continuous noninvasive assessment of tissue oxygenation. Over 20 years ago, near infrared spectroscopy was introduced into clinical practice for monitoring cerebral oxygenation during cardiopulmonary bypass in adults...
August 2016: Pediatric Critical Care Medicine
Takaaki Watanabe, Masato Ito, Fuyu Miyake, Ryo Ogawa, Masanori Tamura, Fumihiko Namba
BACKGROUND: A small oximetry with the sensor attached to the examiner's finger has been developed. The aim of this study was to determine the feasibility of measuring regional oxygenation of the brain tissue using this device during immediate transition of healthy term infants after birth. METHODS: We conducted a prospective observational study. Using a new near-infrared spectroscopy (NIRS) device, we measured changes in regional cerebral tissue oxygen saturation (crSO2 ) during the first 10 min of life in 32 healthy term infants after delivery...
July 25, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
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