TITLE

Correlation of brain tissue oxygen tension with cerebral near-infrared spectroscopy and mixed venous oxygen saturation during extracorporeal membrane oxygenation

AUTHOR(S)
Tyree, Kreangkai; Tyree, Melissa; DiGeronimo, Robert
PUB. DATE
September 2009
SOURCE
Perfusion;Sep2009, Vol. 24 Issue 5, p325
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The aim of this prospective, animal study was to compare brain tissue oxygen tension (PbtO2) with cerebral near infrared spectroscopy (NIRS) and mixed venous oxygen saturation (SVO2) during venoarterial extracorporeal membrane oxygenation (VA ECMO) in a porcine model. This was accomplished using twelve immature piglets with surgically implanted catheters placed in the superficial cerebral cortex to measure brain PbtO2 and microdialysis metabolites. The NIRS sensor was placed overlying the forehead to measure cerebral regional saturation index (rSO2i) while SVO2 was measured directly from the ECMO circuit. Animals were placed on VA ECMO followed by an initial period of stabilization, after which they were subjected to graded hypoxia and recovery. Our results revealed that rSO2i and SVO2 correlated only marginally with PbtO2 (R2=0.32 and R2=0.26, respectively) while the correlation between rSO2i and SVO2 was significantly stronger (R2=0.59). Cerebral metabolites and rSO2i were significantly altered during attenuation of PbtO2, p<0.05). A subset of animals, following exposure to hypoxia, experienced markedly delayed recovery of both rSO2i and PbtO2 despite rapid normalization of SVO2. Upon further analysis, these animals had significantly lower blood pressure (p=0.001), lower serum pH (p=0.01), and higher serum lactate (p=0.02). Additionally, in this subgroup, rSO2i correlated better with PbtO2 (R2=0.76). These findings suggest that, in our ECMO model, rSO2i and SVO2 correlate reasonably well with each other, but not necessarily with brain PbtO2 and that NIRS-derived rSO2i may more accurately reflect cerebral tissue hypoxia in sicker animals.
ACCESSION #
47506204

 

Related Articles

  • Age-dependent effects of gradual decreases in cerebral perfusion pressure on the neurochemical response in swine. Walter, Bernd; Aisenpreis, Kristina; Fritz, Harald G.; Soukup, Jens; Eiselt, Michael; Bauer, Reinhard // Intensive Care Medicine;Jun2010, Vol. 36 Issue 6, p1067 

    There is still a lack of knowledge on the age-dependent relation between a reduction in cerebral perfusion pressure (CPP) and compromised brain perfusion leading to excessive transmitter release and brain damage cascades. The hypothesis is that an age-dependent lower threshold of cerebral blood...

  • Acute kidney injury is a frequent complication in critically ill neonates receiving extracorporeal membrane oxygenation: a 14-year cohort study. Zwiers, Alexandra J. M.; De Wildt, Saskia N.; Hop, Wim C. J.; Dorresteijn, Eiske M.; Gischler, Saskia J.; Tibboel, Dick; Cransberg, Karlien // Critical Care;2013, Vol. 17 Issue 4, p1 

    Introduction: Newborns in need of extracorporeal membrane oxygenation (ECMO) support are at high risk of developing acute kidney injury (AKI). AKI may occur as part of multiple organ failure and can be aggravated by exposure to components of the extracorporeal circuit. AKI necessitates...

  • First experiences with a combined usage of veno-arterial and veno-venous ECMO in therapy-refractory cardiogenic shock patients with cerebral hypoxemia. Moravec, R; Neitzel, T; Stiller, M; Hofmann, B; Metz, D; Bucher, M; Silber, R; Bushnaq, H; RaspĂ©, C // Perfusion;May2014, Vol. 29 Issue 3, p200 

    The use of extracorporeal membrane oxygenation (ECMO) is becoming a popular tool in the treatment of cardiogenic shock. We present two case reports where classical veno-arterial peripherally cannulated ECMO therapy proved insufficient with profuse cerebral hypoxemia. After augmenting the setting...

  • Sildenafil exposure in neonates with pulmonary hypertension after administration via a nasogastric tube. Ahsman, Maurice J.; Witjes, Bregje C.; Wildschut, Enno D.; Sluiter, Ilona; Vulto, Arnold G.; Tibboel, Dick; Mathot, Ron A. // Archives of Disease in Childhood -- Fetal & Neonatal Edition;Feb2010, Vol. 95 Issue 2, pF109 

    Objective To describe the pharmacokinetics and exposure of oral sildenafil (SIL) in neonates (2-5 kg) with pulmonary hypertension (PH). Design We included 11 neonates (body weight 2-5 kg, postnatal age 2-121 days) who received SIL and extracorporeal membrane oxygenation (ECMO) treatment for PH....

  • Morphine metabolite pharmacokinetics during venoarterial extra corporeal membrane oxygenation in neonates. Peters, Jeroen W. B.; Anderson, Brian J.; Simons51, Sinno H. P.; Uges, Donald R. A.; Tibboel, Dick; Simons, Sinno H P // Clinical Pharmacokinetics;2006, Vol. 45 Issue 7, p705 

    Objective: To examine morphine metabolite serum concentrations in neonates undergoing venoarterial extra corporeal membrane oxygenation (ECMO) and to quantify clearance differences between these neonates and those subjected to noncardiac major surgery.Patients and Methods:...

  • Population Pharmacokinetics of Midazolam and Its Metabolites during Venoarterial Extracorporeal Membrane Oxygenation in Neonates. Ahsman, Maurice J.; Hanekamp, Manon; Wildschut, Enno D.; Tibboel, Dick; Mathot, Ron A. A. // Clinical Pharmacokinetics;2010, Vol. 49 Issue 6, p407 

    Background and Objective: Midazolam is used to sedate children during extracorporeal membrane oxygenation (ECMO). Pharmacokinetic changes are expected because of extracorporeal circulation and maturation. We present a population pharmacokinetic model for midazolam and its major metabolites in...

  • Hermes. Singh, Sudha Pradumna // Pediatric Radiology;Aug2008, Vol. 38 Issue 8, p924 

    The article presents abstracts on medical topics including the role of cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO) to distal tracheal stenosis in newborn infants, the correlation of metaphyseal changes in the proximal femur with the symptom duration and demographic...

  • Cerebral extracellular lactate increase is predominantly nonischemic in patients with severe traumatic brain injury. Sala, Nathalie; Suys, Tamarah; Zerlauth, Jean-Baptiste; Bouzat, Pierre; Messerer, Mahmoud; Bloch, Jocelyne; Levivier, Marc; Magistretti, Pierre J; Meuli, Reto; Oddo, Mauro // Journal of Cerebral Blood Flow & Metabolism;Nov2013, Vol. 33 Issue 11, p1815 

    Growing evidence suggests that endogenous lactate is an important substrate for neurons. This study aimed to examine cerebral lactate metabolism and its relationship with brain perfusion in patients with severe traumatic brain injury (TBI). A prospective cohort of 24 patients with severe TBI...

  • The clinical validity of the absolute value of near infrared spectroscopy. YOSHITANI, KENJI; OHNISHI, YOSHIHIKO // Journal of Anesthesia;2008, Vol. 22 Issue 4, p502 

    The article discusses how previous studies have clarified the difficulties in performing accurate near-infrared spectroscopy (NIRS) measurements that has been used clinically as a noninvasive and continuous monitor in cerebral oxygen saturation. The contamination of NIRS measurement by...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics