Correlation Between Cerebral Tissue Oxygen Saturation and Oxygen Extraction Fraction During Anesthesia: Monitoring Cerebral Metabolic Demand-supply Balance During Vasopressor Administration.

Autor:	Koch KU; Department of Anesthesiology, Section of Neuroanesthesia., Zhao X; Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China., Mikkelsen IK; Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus., Espelund US; Department of Anesthesiology, Horsens Regional Hospital, Horsens, Denmark., Aanerud J; Department of Nuclear Medicine and PET Center, Aarhus University Hospital., Rasmussen M; Department of Anesthesiology, Section of Neuroanesthesia., Meng L; Department of Anesthesiology, Yale University School of Medicine, New Haven, CT.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgical anesthesiology [J Neurosurg Anesthesiol] 2023 Apr 01; Vol. 35 (2), pp. 238-242. Date of Electronic Publication: 2021 Dec 02.
DOI:	10.1097/ANA.0000000000000822
Abstrakt:	Background: The speculation that cerebral tissue oxygen saturation (SctO 2 ) measured using tissue near-infrared spectroscopy reflects the balance between cerebral metabolic rate of oxygen and cerebral oxygen delivery has not been validated. Our objective was to correlate SctO 2 with cerebral oxygen extraction fraction (OEF) measured using positron emission tomography; OEF is the ratio between cerebral metabolic rate of oxygen and cerebral oxygen delivery and reflects the balance between these 2 variables. Materials and Methods: This cohort study was based on data collected in a previously published trial assessing phenylephrine versus ephedrine treatment in anesthetized patients undergoing brain tumor surgery. The variables of interest were measured twice over the healthy hemisphere before surgery: the first measurement performed after anesthesia induction and the second measurement performed after induction of a ∼20% increase in blood pressure using either phenylephrine or ephedrine. Results: Data from 24 patients were analyzed. The overall vasopressor-induced relative changes in SctO 2 (ΔSctO 2 ) and OEF (ΔOEF) were 3.16% [interquartile range, -0.73% to 6.04%] and -12.5% [interquartile range, -24.0% to -6.19%], respectively. ΔSctO 2 negatively correlated with ΔOEF after phenylephrine treatment (Spearman rank correlation coefficient [ rs ]=-0.76; P =0.007), ephedrine treatment ( rs =-0.76; P =0.006), and any treatment ( rs =-0.79; P <0.001). ΔSctO 2 significantly associated with ΔOEF based on multivariable analysis with ΔOEF, relative changes in mean arterial pressure, arterial blood oxygen tension, and the bispectral index as covariates ( P =0.036). Conclusions: The negative correlation between changes in SctO 2 and OEF suggests that SctO 2 may reflect the cerebral metabolic demand-supply balance during vasopressor treatment. The generalizability of our findings in other clinical scenarios remains to be determined. Competing Interests: L.M. received consultant fees from Edwards Lifesciences. M.R. has received funding from the Health Research Foundation of Central Denmark Region. The remaining authors have no conflicts of interest to disclose. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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