Cerebral oxygen monitoring during neonatal cardiopulmonary bypass and deep hypothermic circulatory arrest

Thorac Cardiovasc Surg. 2002 Apr;50(2):77-81. doi: 10.1055/s-2002-26698.

Abstract

Background: This study was undertaken to investigate the physiological effects of cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA) on cerebral oxygen metabolism estimated by near-infrared spectroscopy (NIRS).

Methods: Ten newborn piglets (2.1 to 2.6 kg) were monitored with right frontal NIRS; the right jugular bulb was cannulated for intermittent sampling of jugular venous blood. All animals underwent CPB, cooling to a core temperature below 15 degrees C, 60 minutes of DHCA followed by subsequent reperfusion and rewarming. Continuously recorded NIRS data and intermittent jugular venous blood values were compared.

Results: NIRS performance was examined over the jugular venous oxygen saturation (SjvO2) range of 40 to 98 %, a linear correlation was found between SjvO2 and NIRS-derived regional cerebral oxygen saturation (rSO2) (r = 0.91, p < 0.001). A correlation was observed between the cellular oxidation NIRS-parameter cytochrome oxidase aa3 (CytOx) slope during the DHCA period in relation to rectal and nasopharyngeal temperature immediately before the onset of DHCA (r = 0.75 and 0.85, p < 0.001).

Conclusions: This study suggests that NIRS-measured hemoglobin oxygenation parameters may reflect functional changes in cerebral hemodynamics and brain tissue oxygenation, while CytOx values represent related effects on intracellular oxidative metabolism.

MeSH terms

  • Animals
  • Animals, Newborn
  • Brain / blood supply
  • Brain / metabolism*
  • Cardiopulmonary Bypass*
  • Cerebrovascular Circulation / physiology
  • Heart Arrest, Induced*
  • Hypothermia, Induced*
  • Models, Animal
  • Monitoring, Intraoperative / instrumentation*
  • Monitoring, Intraoperative / methods
  • Oxygen Consumption / physiology*
  • Reproducibility of Results
  • Spectroscopy, Near-Infrared
  • Swine