1 / 9

Conflict of interest - none

What is the relationship between near infrared spectroscopic regional mixed arterio-venous oxygen saturation and jugular bulb venous saturation during core cooling and bilateral selective antegrade cerebral perfusion?.

mayten
Download Presentation

Conflict of interest - none

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. What is the relationship between near infrared spectroscopic regional mixed arterio-venous oxygen saturation and jugular bulb venous saturation during core cooling and bilateral selective antegrade cerebral perfusion? Vamsidhar B Dronavalli, Ashvini Menon, Ishtiaq Rahman, David Green, Timothy Jones, Jorge Mascaro, Robert S Bonser Department of Cardiothoracic Surgery, University Hospital Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK. Conflict of interest - none

  2. Aim • To assess near infrared spectroscopy (NIRS) as a regional index of mixed arterio-venous cortical saturation (rSO2 ) in managing patients during core cooling (CC)

  3. Introduction Increasing jugular bulb venous oxygen saturation(SjO2) during CC correlates with reducing brain O2 consumption and guides safe commencement of hypothermic circulatory arrest (HCA). NIRS a regional index of rSO2 has been advocated as a surrogate of SjO2.

  4. Methodology • 9 patients undergoing CC • Utilising NIRS, rSO2 was measured • At 35oC, 30oC, 25oC and 15oC during CC • At 5, 15 ,30 and 45 mins of SACP • At 15oC, 20oC, 25oC ,30oC and 35oC during warming • Utilising a jugular bulb line venous oxygen saturation, SjO2 was measured at similar time points • Standardised anaesthetic and bypass protocol

  5. The patients 15 patients 5x Ascending aortic aneurysm and arch aneurysm 2x Mega aortic syndrome 1X chronic type A dissection 1x Pseudo aneurysm of distal arch and proximal descending Mean age=55 Diagnosis 7x Ascending aorta + arch + elephant trunk ± Aortic valve replacement 2x Ascending aorta+ arch replacement Procedures

  6. Results Both rSO2 and SjO2 increased with cooling p<0.01 and p=0.03 repectively

  7. rSO2 and SjO2vs temperature change

  8. Scatter plot of SjO2% vs rSO2%

  9. Conclusion NIRS rSO2 assessment during CC underestimates SjO2 for reasons that remain unclear. Regional SO2 is paradoxically lower than SjO2 during CC and our data raises questions of what each index of oxygen extraction is actually measuring.

More Related