The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy
Abstract Objective/Introduction: Near-infrared spectroscopy (NIRS) is a non-invasive technique to detect cerebral ischemia by monitoring changes in regional cerebral oxygenation (rSO2) in the frontal lobes. However, there are no studies showing the changes in NIRS values in response to hemodynamic...
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| Format: | Article |
| Language: | English |
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Sociedade Brasileira de Cirurgia Cardiovascular
2021-12-01
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| Series: | Brazilian Journal of Cardiovascular Surgery |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021005008206&tlng=en |
| _version_ | 1828816176213393408 |
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| author | Cihan Yücel Serkan Ketenciler Mete Gürsoy Seray Türkmen Nihan Kayalar |
| author_facet | Cihan Yücel Serkan Ketenciler Mete Gürsoy Seray Türkmen Nihan Kayalar |
| author_sort | Cihan Yücel |
| collection | DOAJ |
| description | Abstract Objective/Introduction: Near-infrared spectroscopy (NIRS) is a non-invasive technique to detect cerebral ischemia by monitoring changes in regional cerebral oxygenation (rSO2) in the frontal lobes. However, there are no studies showing the changes in NIRS values in response to hemodynamic variations during stages of carotid endarterectomy (CEA) procedure and clinical implications of these changes. The aim of this study was to determine if hemodynamic changes affect NIRS values during carotid endarterectomy and if our results may help to provide strategies for hemodynamic management in these patients. Methods: A total of 50 consecutive patients undergoing CEA were prospectively included in the study. NIRS was measured at first minute after clamping of carotid artery, and then systolic blood pressure was increased above 150 mmHg. NIRS values from both hemispheres were recorded simultaneously at certain time points and were analyzed to evaluate the changes at different stages of operation and to assess correlations with hemodynamic parameters. Results: NIRS values on the right and left sides were correlated with systolic (right P<0.001, R2:0.24; left P=0.02, R2:0.10) diastolic (right P<0.001, R2:0.36; left P=0.001, R2:0.18) and mean (right P<0.001, R2:0.33; left P=0.003, R2:0.17) blood pressures when the patient was under general anaesthesia. NIRS values were significantly lower than pre-incision values just after clamping of carotid artery in both hemispheres (P=0.005 for the right and P<0.001 for the left side). Conclusion: NIRS values measured in our study show that there is a correlation between hemodynamic changes and cerebral oxygenation. This effect is especially pronounced while the patient is asleep and intubated, which implies the importance of close monitoring of patients with carotid disease during any surgery requiring general anaesthesia. |
| first_indexed | 2024-12-12T10:58:21Z |
| format | Article |
| id | doaj.art-9017838f124449a5b1ada4b8024e93d2 |
| institution | Directory Open Access Journal |
| issn | 1678-9741 |
| language | English |
| last_indexed | 2024-12-12T10:58:21Z |
| publishDate | 2021-12-01 |
| publisher | Sociedade Brasileira de Cirurgia Cardiovascular |
| record_format | Article |
| series | Brazilian Journal of Cardiovascular Surgery |
| spelling | doaj.art-9017838f124449a5b1ada4b8024e93d22022-12-22T00:26:36ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-97412021-12-0110.21470/1678-9741-2020-0398The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid EndarterectomyCihan Yücelhttps://orcid.org/0000-0002-1941-0873Serkan KetencilerMete GürsoySeray TürkmenNihan KayalarAbstract Objective/Introduction: Near-infrared spectroscopy (NIRS) is a non-invasive technique to detect cerebral ischemia by monitoring changes in regional cerebral oxygenation (rSO2) in the frontal lobes. However, there are no studies showing the changes in NIRS values in response to hemodynamic variations during stages of carotid endarterectomy (CEA) procedure and clinical implications of these changes. The aim of this study was to determine if hemodynamic changes affect NIRS values during carotid endarterectomy and if our results may help to provide strategies for hemodynamic management in these patients. Methods: A total of 50 consecutive patients undergoing CEA were prospectively included in the study. NIRS was measured at first minute after clamping of carotid artery, and then systolic blood pressure was increased above 150 mmHg. NIRS values from both hemispheres were recorded simultaneously at certain time points and were analyzed to evaluate the changes at different stages of operation and to assess correlations with hemodynamic parameters. Results: NIRS values on the right and left sides were correlated with systolic (right P<0.001, R2:0.24; left P=0.02, R2:0.10) diastolic (right P<0.001, R2:0.36; left P=0.001, R2:0.18) and mean (right P<0.001, R2:0.33; left P=0.003, R2:0.17) blood pressures when the patient was under general anaesthesia. NIRS values were significantly lower than pre-incision values just after clamping of carotid artery in both hemispheres (P=0.005 for the right and P<0.001 for the left side). Conclusion: NIRS values measured in our study show that there is a correlation between hemodynamic changes and cerebral oxygenation. This effect is especially pronounced while the patient is asleep and intubated, which implies the importance of close monitoring of patients with carotid disease during any surgery requiring general anaesthesia.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021005008206&tlng=enAtherosclerosis. Carotid Endarterectomy. Near-Infrared Spectroscopy. Carotid ArteryCommon. AnesthesiaGeneral |
| spellingShingle | Cihan Yücel Serkan Ketenciler Mete Gürsoy Seray Türkmen Nihan Kayalar The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy Brazilian Journal of Cardiovascular Surgery Atherosclerosis. Carotid Endarterectomy. Near-Infrared Spectroscopy. Carotid Artery Common. Anesthesia General |
| title | The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy |
| title_full | The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy |
| title_fullStr | The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy |
| title_full_unstemmed | The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy |
| title_short | The Effect of Hemodynamic Parameters on Cerebral Oxygenization During Carotid Endarterectomy |
| title_sort | effect of hemodynamic parameters on cerebral oxygenization during carotid endarterectomy |
| topic | Atherosclerosis. Carotid Endarterectomy. Near-Infrared Spectroscopy. Carotid Artery Common. Anesthesia General |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382021005008206&tlng=en |
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