Journals / Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi / 2017 / Cilt: 23 - Sayı: 1

Monitorisation of Cerebral Oxygenation in Cardiac Surgeries with and Without Cardiotomy

Açık Kalp Cerrahisinde Kapak ve Koroner Ameliyatlarında Serebral Oksijenasyon Monitörizasyonu

Pages
8–14
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: In our study, no significant difference was found between the parameters and the changes in the NIRS measurements during the time intervals between the valve and coronary surgery groups.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: Cerebral oxygen monitorisation with nearinfrared spectroscopy (NIRS) during cardiovascular surgery is a method with increasing value.
📊
Key Findings & Data:Material and Method: Forty patients who underwent elective valvular surgery by cardiopulmonar bypass (Group 1) and coronary artery bypass grafting (Group 2) were enrolled in our study.
💡
Conclusion & Impact:Conclusion: In our study, no significant difference was found between the parameters and the changes in the NIRS measurements during the time intervals between the valve and coronary surgery groups.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: Cerebral oxygen monitorisation with nearinfrared spectroscopy (NIRS) during cardiovascular surgery is a method with increasing value. We aimed to investigate differences in cerebral oxygenation in patients who underwent valvular, and coronary surgery in our study. Material and Method: Forty patients who underwent elective valvular surgery by cardiopulmonar bypass (Group 1) and coronary artery bypass grafting (Group 2) were enrolled in our study. Patients' NIRS values, arterial blood pressures, heart rates, oxygenation, hematocrite and lactate levels were recorded in 7 time periods as before and after anesthesia induction, during canulation, 5th min. of cardiopulmonary bypass, and when nadir temperature is reached, 5th min. after cardiopulmonary bypass and at the end of the operation.Results: Any intergroup difference was not detected as for demographic features of the patients and operation times. In Group 1 cross- clamping and CPB times were prolonged. Between groups; Hemodynamic data, right and left NIRS values were not different between groups. Intragroup right and left NIRS values were also compaarable. In Group 1 inotropic support in ICU was significantly higher. ICU stay and extubation times were similar between groups. 24th hour major neurological examination of the patients at postoperative 24th hour were also within normal limits. Conclusion: In our study, no significant difference was found between the parameters and the changes in the NIRS measurements during the time intervals between the valve and coronary surgery groups.

Özet

Amaç: Kardiyovasküler cerrahi sırasında near infrared spektroskopi (NIRS) ile serebral oksijenizasyon monitörizasyonu değeri gittikçe artan bir metotdur. Çalışmamızda, kapak cerrahisi ve koroner cerrahisi geçiren hastalarda serebral oksijenizasyon farklılıklarını araştırmayı hedefledik.Gereç ve Yöntem: Kardiyopulmoner baypas (KPB) kullanılarak elektif kapak operasyonu (grup 1) ve koroner arter baypas greftleme (grup 2) operasyonu planlanan 40 hasta çalışmaya alındı. Hastaların NIRS değerleri, arteriyel kan basınçları, kalp hızı, oksijenasyon, hematokrit, laktat değerleri; indüksiyon öncesi, indüksiyon sonrası, kanülasyon sırasında, KPB'a girildikten 5 dk. sonra, KPB'ta en düşük ısıda, KPB'tan çıktıktan 5 dk. sonra ve operasyon sonunda olmak üzere 7 dönemde kaydedildi. Bulgular: Gruplar arasında, hastaların demografik özellikleri, operasyon süreleri farklı saptanmadı. Grup l'de kros-klemp ve KPB sürelerinin uzun olduğu saptandı. Gruplarda hemodinamik veriler, sağ-sol NIRS değerleri farklı bulunmadı. Grupların kendi içinde değerlendirilen sağ-sol NIRS değerleri de benzerdi. Yoğun bakımda in-otropik ilaç desteği Grup 1'de anlamlı olarak yüksekti.Yoğun bakımda kalış süreleri, ekstübasyon zamanları açısından gruplar birbirine benzer bulundu. Hastaların postoperatif 24. saatteki majör nörolojik muayeneleri normaldi.Sonuç: Çalışmamızda, kapak ve koroner cerrahisi hasta grupları arasında belirlenen zaman aralıklarında takip ettiğimiz parametreler ve NIRS ölçümlerindeki değişimler açısından anlamlı farklılık saptanmadı.

🔖

Cite This Article

TÜRKYILMAZ, G. G., KARADENİZ, Ü., DEMİR, Z. A., KEMERCİ, P., KOÇULU, R., BİNDAL, M., ERTÜRK*, A., ÖZGÖK, A. (2017). Monitorisation of Cerebral Oxygenation in Cardiac Surgeries with and Without Cardiotomy. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, Cilt: 23 - Sayı: 1, 8–14. https://ajindex.com/articles/215422

References (11)

  1. Douds MT, Straub EJ, Kent AC, Bistrick CH, Sistino JJ. A systematic review of cerebral oxygenationmonitoring devices in cardiac surgery. Perfusion 2014;29:545-52.
  2. Zheng F, Sheinberg R, Yee MS, Ono M, Zheng Y, Hogue CW. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg 2013, 116:663-76.
  3. Vretzakis G, Georgopoulou S, Stamoulis K, Stamatiou G, Tsakiridis K, Zarogoulidis P, et al. Cerebral oximetry in cardiac anesthesia. J Thorac Dis 2014;6 Suppl 1:S60-9
  4. Slater JP, Guarino T, Stack J, Vinod K, Bustami RT, Brown JM 3rd et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg 2009;87(1):36-44.
  5. Toraman F, Erkek E, Güçlü P, Sayın J, Arıtürk C, Ökten EM. et al. Near İnfra Red Spektroskopisi (NIRS) Gerçekten Doku Saturasyonunu Ölçüyor mu? Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2013; 4(3):115-7
  6. Denault A, Deschamps A, Murkin JM. A Proposed Algorithm for the intraoperative use of cerebral nearinfrared spectroscopy. Semin Cardiothorac Vasc Anesth 2007;11:274
  7. Goldman S, Sutter F, Ferdinand F, Trace C. Optimizing intraoperative cerebral oxygen delivery using noninvasive cerebral oximetry decreases the incidence of stroke for cardiac surgical patients. Heart Surg Forum 2004;7:E376-81.
  8. Yao FS, Tseng CC, Ho CY, Levin SK, Illner P. Cerebral oxygen desaturation is associa-ted with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2004;18(5):552-8.
  9. Fischer GW, Lin HM, Krol M, Galati MF, Di Luozzo G, Griepp RB et al. Noninvasive cerebral oxygenation may predict outcome in patients undergoing aortic arch surgery. J Thorac Cardiovasc Surg 2011;141:815-21.
  10. Austin EH 3rd, Edmonds HL Jr, Auden SM, Seremet V, Niznik G, Sehic A et al. Benefit of neurophysiologic monitoring for pediatric cardiac surgery. J Thorac Cardiovasc Surg 1997;114:707-15, 717; discussion 715-706
  11. ElBardissi AW, Aranki SF, Sheng S, O'Brien SM, Greenberg CC, Gammie JS. Trends in isolated coronary artery bypass grafting: an analysis of the Society of Thoracic Surgeons adult cardiac surgery d