| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | European Journal of Anaesthesiology | ||||
| Publisher: | LIPPINCOTT WILLIAMS & WILKINS | ||||
| Place of Publication: | PHILADELPHIA | ||||
| Volume: | 27 | ||||
| Number of Issue or Book Chapter: | 6 | ||||
| Page Range: | pp. 542-549 | ||||
| Date: | 2010 | ||||
| Institutions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien | ||||
| Identification Number: |
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| Keywords: | PREDICTS COGNITIVE DECLINE; CONGESTIVE-HEART-FAILURE; RISK-ADJUSTED MORTALITY; VASCULAR SMOOTH-MUSCLE; LONGER HOSPITAL STAY; CAROTID-ENDARTERECTOMY; OXYGEN-SATURATION; CARDIAC-SURGERY; BLOOD-FLOW; SEVOFLURANE; intraoperative monitoring; off-pump coronary artery bypass; near-infrared spectroscopy | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 66046 |
Web of ScienceAbstract
Background and objective The present study investigated whether positioning of the heart during off-pump coronary artery bypass grafting leads to changes in regional cerebral oxygen saturation measured by near infrared spectroscopy. Methods In 35 consecutive patients undergoing elective off-pump coronary artery bypass grafting, cerebral oxygen saturation was measured by near infrared ...
Abstract
Background and objective The present study investigated whether positioning of the heart during off-pump coronary artery bypass grafting leads to changes in regional cerebral oxygen saturation measured by near infrared spectroscopy. Methods In 35 consecutive patients undergoing elective off-pump coronary artery bypass grafting, cerebral oxygen saturation was measured by near infrared spectroscopy. A 20% decrease from baseline values was considered to be cerebral hypoperfusion. Mean arterial pressure, cardiac index, arterial carbon dioxide partial pressure, central venous pressure, haemoglobin concentration, and body temperature were determined simultaneously. Each value was recorded at the following time points: at baseline; after positioning the heart for distal anastomoses of the left anterior descending artery, the circumflex, and the right coronary artery; after repositioning the heart; and after chest closure. Significant changes in each parameter from baseline were detected using repeated-measures analysis of variance. Determinants of cerebral oxygen saturation during surgery were analysed by means of generalized estimation equations. Results Cerebral oxygen saturation remained constant during grafting of the left anterior descending artery and decreased significantly during grafting of the circumflex (P=0.001) and the right coronary artery (P<0.001). Cerebral hypoperfusion was found in seven (20%) patients. Changes in haemoglobin concentration (P=0.014), arterial CO(2) partial pressure (P=0.001), cardiac output (P<0.001), and central venous pressure (P=0.014) determined alterations in cerebral oxygen saturation. Conclusion Positioning of the heart during off-pump coronary artery bypass grafting leads to a decrease in regional cerebral oxygen saturation. This decrease is associated with changes in cardiac output, haemoglobin concentration, arterial CO(2) partial pressure, and central venous pressure. Eur J Anaesthesiol 2010;27:542-549
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