Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
Vasopressor agents may affect cerebral oxygenation (rScO2) as determined by near-infrared spectroscopy on the forehead. This case series evaluated the effect of calcium chloride vs. α and β-adrenergic receptor agonists on rScO2 in patients (n = 47) undergoing surgery during i.v. anesthesia. Mean art...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2014-10-01
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| Series: | Frontiers in Physiology |
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| Online Access: | http://journal.frontiersin.org/Journal/10.3389/fphys.2014.00407/full |
| _version_ | 1819072374833676288 |
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| author | Carl-Christian eKitchen Peter eNissen Niels H Secher Henning Bay Nielsen |
| author_facet | Carl-Christian eKitchen Peter eNissen Niels H Secher Henning Bay Nielsen |
| author_sort | Carl-Christian eKitchen |
| collection | DOAJ |
| description | Vasopressor agents may affect cerebral oxygenation (rScO2) as determined by near-infrared spectroscopy on the forehead. This case series evaluated the effect of calcium chloride vs. α and β-adrenergic receptor agonists on rScO2 in patients (n = 47) undergoing surgery during i.v. anesthesia. Mean arterial pressure (MAP) and cardiac output (CO) were assessed by Model-flow® and ephedrine (55 ± 3 vs. 74 ± 9 mmHg; 10 mg, n = 9), phenylephrine (51 ± 5 vs. 78 ± 9 mmHg, 0.1 mg, n = 11), adrenaline (53 ± 3 vs. 72 ± 11 mmHg; 1 - 2 µg, n = 6), noradrenaline (53 ± 5 vs. 72 ± 12 mmHg; 2-4 µg, n = 11), and calcium chloride (49 ± 7 vs. 57 ± 16 mmHg; 5 mmol, n = 10) increased MAP (all P < 0.05). CO increased with ephedrine (4.3 ± 0.9 vs. 5.3 ± 1.2, P < 0.05) and adrenaline (4.7 ± 1.2 vs. 5.9 ± 1.1 l/min; P = 0.07) but was not significantly affected by phenylephrine (3.9 ± 0.7 vs. 3.6 ± 1.0 l/min), noradrenaline (3.8 ± 1.2 vs. 3.7 ± 0.7 l/min), or calcium chloride (4.0 ± 1.4 vs. 4.1 ± 1.5 l/min). Following administration of β-adrenergic agents and calcium chloride rScO2 was preserved while after administration of α-adrenergic drugs rScO2 was reduced by app. 2% (P < 0.05). Following α-adrenergic drugs to treat anesthesia-induced hypotension tissue oxygenation is reduced while the use of β-adrenergic agonists and calcium chloride preserve tissue oxygenation. |
| first_indexed | 2024-12-21T17:36:43Z |
| format | Article |
| id | doaj.art-d18d65e0b3b24336895bb9a45f036061 |
| institution | Directory Open Access Journal |
| issn | 1664-042X |
| language | English |
| last_indexed | 2024-12-21T17:36:43Z |
| publishDate | 2014-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Physiology |
| spelling | doaj.art-d18d65e0b3b24336895bb9a45f0360612022-12-21T18:55:45ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2014-10-01510.3389/fphys.2014.00407108891Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotensionCarl-Christian eKitchen0Peter eNissen1Niels H Secher2Henning Bay Nielsen3RigshospitaletRigshospitaletRigshospitaletRigshospitaletVasopressor agents may affect cerebral oxygenation (rScO2) as determined by near-infrared spectroscopy on the forehead. This case series evaluated the effect of calcium chloride vs. α and β-adrenergic receptor agonists on rScO2 in patients (n = 47) undergoing surgery during i.v. anesthesia. Mean arterial pressure (MAP) and cardiac output (CO) were assessed by Model-flow® and ephedrine (55 ± 3 vs. 74 ± 9 mmHg; 10 mg, n = 9), phenylephrine (51 ± 5 vs. 78 ± 9 mmHg, 0.1 mg, n = 11), adrenaline (53 ± 3 vs. 72 ± 11 mmHg; 1 - 2 µg, n = 6), noradrenaline (53 ± 5 vs. 72 ± 12 mmHg; 2-4 µg, n = 11), and calcium chloride (49 ± 7 vs. 57 ± 16 mmHg; 5 mmol, n = 10) increased MAP (all P < 0.05). CO increased with ephedrine (4.3 ± 0.9 vs. 5.3 ± 1.2, P < 0.05) and adrenaline (4.7 ± 1.2 vs. 5.9 ± 1.1 l/min; P = 0.07) but was not significantly affected by phenylephrine (3.9 ± 0.7 vs. 3.6 ± 1.0 l/min), noradrenaline (3.8 ± 1.2 vs. 3.7 ± 0.7 l/min), or calcium chloride (4.0 ± 1.4 vs. 4.1 ± 1.5 l/min). Following administration of β-adrenergic agents and calcium chloride rScO2 was preserved while after administration of α-adrenergic drugs rScO2 was reduced by app. 2% (P < 0.05). Following α-adrenergic drugs to treat anesthesia-induced hypotension tissue oxygenation is reduced while the use of β-adrenergic agonists and calcium chloride preserve tissue oxygenation.http://journal.frontiersin.org/Journal/10.3389/fphys.2014.00407/fullBlood PressureBrainCardiac OutputNIRScerebral oxygenationcerebral oximetry |
| spellingShingle | Carl-Christian eKitchen Peter eNissen Niels H Secher Henning Bay Nielsen Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension Frontiers in Physiology Blood Pressure Brain Cardiac Output NIRS cerebral oxygenation cerebral oximetry |
| title | Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension |
| title_full | Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension |
| title_fullStr | Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension |
| title_full_unstemmed | Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension |
| title_short | Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension |
| title_sort | preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia induced hypotension |
| topic | Blood Pressure Brain Cardiac Output NIRS cerebral oxygenation cerebral oximetry |
| url | http://journal.frontiersin.org/Journal/10.3389/fphys.2014.00407/full |
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