Impact of Norepinephrine on Regional Cerebral Oxygenation During Cardiopulmonary Bypass
| Autor: | Ove Andreas Hagen, Per Reidar Woldbaek, André Roslin, Svein Aslak Landsverk, Are Hugo Pripp, R Hanoa, Lars Øivind Høiseth, Knut Arvid Kirkebøen |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Mean arterial pressure Cerebral arteries Cerebral oxygen saturation 030204 cardiovascular system & hematology law.invention Norepinephrine (medication) 03 medical and health sciences Norepinephrine 0302 clinical medicine Oxygen Consumption 030202 anesthesiology law Internal medicine Cardiopulmonary bypass Medicine Humans Vasoconstrictor Agents Arterial Pressure Cardiac Surgical Procedures Aged Brain Chemistry Cardiopulmonary Bypass Spectroscopy Near-Infrared business.industry Carbon Dioxide Middle Aged Cardiac surgery Oxygen Anesthesiology and Pain Medicine Blood pressure Cerebral blood flow Anesthesia Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 30(2) |
| ISSN: | 1532-8422 |
| Popis: | Objectives Norepinephrine is used to increase mean arterial pressure during cardiopulmonary bypass. However, it has been suggested that norepinephrine could constrict cerebral arteries, reducing cerebral blood flow. The aim of this study, therefore, was to explore whether there was an association between doses of norepinephrine to maintain mean arterial pressure at ≈80 mmHg during cardiopulmonary bypass and cerebral oxygen saturation measured using near-infrared spectroscopy. Design Observational study. Setting University hospital. Participants Patients undergoing cardiac surgery (n = 45) using cardiopulmonary bypass. Interventions Norepinephrine was administered to maintain mean arterial pressure ≈80 mmHg during cardiopulmonary bypass. Measurements and Main Results From initiation of cardiopulmonary bypass to removal of the aortic cross-clamp, norepinephrine dose, mean arterial pressure, partial pressure of arterial carbon dioxide, partial pressure of arterial oxygen, hemoglobin, and pump flow values were averaged over 1 minute, giving a total of 3,460 data points entered as covariates in a linear mixed model for repeated measurements, with cerebral oxygen saturation measured using near-infrared spectroscopy as outcome. There was no statistically significant association between norepinephrine dose to maintain mean arterial pressure and cerebral oxygen saturation (p = 0.46) in this model. Conclusions Administration of norepinephrine to maintain mean arterial pressure ≈80 mmHg during cardiopulmonary bypass was not associated with statistically significant changes in cerebral oxygen saturation. These results indicated that norepinephrine could be used to increase mean arterial pressure during cardiopulmonary bypass without reducing cerebral oxygen saturation. |
| Databáze: | OpenAIRE |
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