Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults
<b>Background :</b>Changes in oxygenation occur during one-lung ventilation (OLV) due to intrapulmonary shunt. Although arterial oxygenation is generally adequate, there are no studies evaluating the effect of these changes on cerebral oxygenation. <b>Materials and Methods :</b&...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2008-01-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2008;volume=4;issue=4;spage=104;epage=107;aulast=Tobias |
| _version_ | 1818520995963600896 |
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| author | Tobias Joseph Johnson Garry Rehman Saif Fisher Robert Caron Norman |
| author_facet | Tobias Joseph Johnson Garry Rehman Saif Fisher Robert Caron Norman |
| author_sort | Tobias Joseph |
| collection | DOAJ |
| description | <b>Background :</b>Changes in oxygenation occur during one-lung ventilation (OLV) due to intrapulmonary shunt. Although arterial oxygenation is generally adequate, there are no studies evaluating the effect of these changes on cerebral oxygenation. <b>Materials and Methods :</b>Cerebral oxygenation (rSO<sub> 2</sub> ), heart rate (HR), blood pressure (BP), oxygen saturation (SaO<sub> 2</sub> ), and end-tidal carbon dioxide (ETCO<sub> 2</sub> ) were prospectively monitored during OLV in adults. Cerebral oxygenation was monitored using near infrared spectroscopy. No clinical decisions were made based on the rSO2 value. BP and HR were the inspired oxygen concentration was adjusted as needed to maintain the SaO<sub> 2</sub> ≥ 95%. <b>Results :</b>The study cohort included 40 adult patients. 18,562 rSO<sub> 2</sub> values were collected during OLV. The rSO<sub> 2</sub> was ≥ baseline at 3,593 of the 18,562 data points (19%). The rSO2 was 0-9 ≤ baseline in 7,053 (38%) of the readings, 10-19 ≤ baseline in 4,084 (22%) of the readings, and 20-29 ≤ baseline in 3,898 (21%) of the readings. 2,599 (14%) of the rSO<sub> 2</sub> values were less than 75% of the baseline value. Thirteen patients (32.5%) had at least one rSO2 value that was less than 75% of the baseline. Eight patients (20%) had rSO<sub> 2</sub> values less than 75% of baseline for ≥ 25% of the duration of OLV. These patients were older (63.7 ± 10.2 vs 54.6 ± 9.8 years, <i> P</i> < 0.025), weighed more (95.8 ± 17.4 vs 82.6 ± 14.6 kgs, <i> P</i> =0.038), and were more likely to be ASA III vs II (7 of 8 versus 25 of 32, relative risk 1.75) than the remainder of the cohort. <b>Conclusions :</b>Significant changes in rSO2 occur during OLV for thoracic surgical procedures. Future studies are needed to determine the impact of such changes on the postoperative course of these patients. |
| first_indexed | 2024-12-11T01:45:06Z |
| format | Article |
| id | doaj.art-5a190f9b6b254b1688dd438816ea9a9b |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-12-11T01:45:06Z |
| publishDate | 2008-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-5a190f9b6b254b1688dd438816ea9a9b2022-12-22T01:24:55ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212008-01-0144104107Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adultsTobias JosephJohnson GarryRehman SaifFisher RobertCaron Norman<b>Background :</b>Changes in oxygenation occur during one-lung ventilation (OLV) due to intrapulmonary shunt. Although arterial oxygenation is generally adequate, there are no studies evaluating the effect of these changes on cerebral oxygenation. <b>Materials and Methods :</b>Cerebral oxygenation (rSO<sub> 2</sub> ), heart rate (HR), blood pressure (BP), oxygen saturation (SaO<sub> 2</sub> ), and end-tidal carbon dioxide (ETCO<sub> 2</sub> ) were prospectively monitored during OLV in adults. Cerebral oxygenation was monitored using near infrared spectroscopy. No clinical decisions were made based on the rSO2 value. BP and HR were the inspired oxygen concentration was adjusted as needed to maintain the SaO<sub> 2</sub> ≥ 95%. <b>Results :</b>The study cohort included 40 adult patients. 18,562 rSO<sub> 2</sub> values were collected during OLV. The rSO<sub> 2</sub> was ≥ baseline at 3,593 of the 18,562 data points (19%). The rSO2 was 0-9 ≤ baseline in 7,053 (38%) of the readings, 10-19 ≤ baseline in 4,084 (22%) of the readings, and 20-29 ≤ baseline in 3,898 (21%) of the readings. 2,599 (14%) of the rSO<sub> 2</sub> values were less than 75% of the baseline value. Thirteen patients (32.5%) had at least one rSO2 value that was less than 75% of the baseline. Eight patients (20%) had rSO<sub> 2</sub> values less than 75% of baseline for ≥ 25% of the duration of OLV. These patients were older (63.7 ± 10.2 vs 54.6 ± 9.8 years, <i> P</i> < 0.025), weighed more (95.8 ± 17.4 vs 82.6 ± 14.6 kgs, <i> P</i> =0.038), and were more likely to be ASA III vs II (7 of 8 versus 25 of 32, relative risk 1.75) than the remainder of the cohort. <b>Conclusions :</b>Significant changes in rSO2 occur during OLV for thoracic surgical procedures. Future studies are needed to determine the impact of such changes on the postoperative course of these patients.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2008;volume=4;issue=4;spage=104;epage=107;aulast=TobiasCerebral oxygenationnear infrared spectroscopyone-lung ventilationthoracic surgerythoracoscopy |
| spellingShingle | Tobias Joseph Johnson Garry Rehman Saif Fisher Robert Caron Norman Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults Journal of Minimal Access Surgery Cerebral oxygenation near infrared spectroscopy one-lung ventilation thoracic surgery thoracoscopy |
| title | Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults |
| title_full | Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults |
| title_fullStr | Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults |
| title_full_unstemmed | Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults |
| title_short | Cerebral oxygenation monitoring using near infrared spectroscopy during one-lung ventilation in adults |
| title_sort | cerebral oxygenation monitoring using near infrared spectroscopy during one lung ventilation in adults |
| topic | Cerebral oxygenation near infrared spectroscopy one-lung ventilation thoracic surgery thoracoscopy |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2008;volume=4;issue=4;spage=104;epage=107;aulast=Tobias |
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