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Near-infrared spectroscopy as a possible device for continuous monitoring of arterial carbon dioxide tension during cardiac surgery.
MedLine Citation:
PMID:  21844113     Owner:  NLM     Status:  Publisher    
BACKGROUND: Insufflation of carbon dioxide (CO(2)) to the operative field has been used to prevent major organ injury attributed to air embolisms in cardiac surgery. However, it may be preferable to avoid hypercapnia induced by CO(2) insufflation, owing to its potentially harmful effect. To investigate the effectiveness of near-infrared spectroscopy (NIRS) as a possible method for continuous monitoring of arterial CO(2) tension during cardiac surgery, we evaluated the correlation between the change in arterial CO(2) tension and the change in regional cerebral oxygen saturation (rScO(2)) obtained from NIRS in as controlled a condition as possible. METHODS: Thirty patients who underwent surgical correction for atrial or ventricular septal defects were enrolled in this study. Patients who had pulmonary hypertension or other intracardiac anomalies were excluded. Anesthetic and cardiopulmonary bypass (CPB) management were conducted according to our standard institutional practice. Data obtained from arterial blood gas analyses and corresponding regional cerebral oxygen saturation (rScO(2)) recorded from NIRS before and after the insufflations of CO(2) during CPB were used for analysis. RESULTS: The change in arterial CO(2) tension correlated with the change in rScO(2) in the left hemisphere (r = 0.681, p <0.001, y = -1.393 + 0.547x) and right hemisphere (r = 0.690, p <0.001, y = -1.999 + 0.486x). To control the effects of other variables, including hematocrit and temperature, these relationship were not reduced (left hemisphere: r=0.678, p <0.001; right hemisphere: r=0.634, p<0.001). CONCLUSIONS: Since the change in regional cerebral oxygen saturation was correlated with the change in arterial CO(2) tension during mild hypothermic CPB, NIRS might be a possible non-invasive method for monitoring of arterial CO(2) tension without incurring additional cost in this setting.
C S Park; J G Kwak; C Lee; C-H Lee; S K Lee; Y L Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-15
Journal Detail:
Title:  Perfusion     Volume:  -     ISSN:  1477-111X     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital, Sejong Heart Institute, Bucheon, Republic of Korea.
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