Elevated intrathoracic CO2 pressure during thoracoscopic surgery decreases regional cerebral oxygen saturation in neonates and infants-A pilot study
| Autor: | Felix Neunhoeffer, Matthias Kumpf, Alisa Müller, Michael Hofbeck, Hans-Joachim Kirschner, Guido Seitz, Frank Fideler, Jörg Fuchs, Steven W. Warmann, Martin U. Schuhmann |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Cerebral oxygen saturation Blood flow Laser Doppler velocimetry Surgery 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine 030225 pediatrics Anesthesia Pediatrics Perinatology and Child Health medicine Thoracoscopy medicine.symptom business Hypercapnia 030217 neurology & neurosurgery Oxygen saturation (medicine) Abdominal surgery Acidosis |
| Zdroj: | Pediatric Anesthesia. 27:752-759 |
| ISSN: | 1155-5645 |
| Popis: | BACKGROUND Intraoperative hypercapnia and acidosis are risk factors during thoracoscopy in neonates and infants. METHODS In a prospective pilot study, we evaluated the effects of thoracoscopy in neonates and infants on cerebral microcirculation, oxygen saturation, and oxygen consumption. Regional cerebral oxygen saturation and blood flow were measured noninvasively using a new device combining laser Doppler flowmetry and white light spectrometry. Additionally, cerebral fractional tissue oxygen extraction and approximated oxygen consumption were calculated. Fifteen neonates and infants undergoing thoracoscopy were studied using the above-mentioned method. The chest was insufflated with carbon dioxide with a pressure of 2-6 mm Hg. Single lung ventilation was not used. As control group served 15 neonates and infants undergoing abdominal surgery. RESULTS Data are presented as median and range. The 95% confidence intervals for differences of means (95% CI) are given for the mean difference from baseline values. We observed a correlation between intrathoracic pressure exceeding 4 mm Hg and transient decrease in regional cerebral oxygen saturation of 12.7% (95% CI: 9.7-17.2, P 4 mm Hg should be avoided during thoracoscopic surgery. |
| Databáze: | OpenAIRE |
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