期刊文献+

以脑氧饱和度监测为导向维护体外循环冠脉搭桥手术期间脑氧供需平衡 被引量:8

Maintenance of cerebral oxygen balance by the guide of cerebral tissue oxygen saturation monitoring during coronary artery bypass grafting surgery
暂未订购
导出
摘要 目的探讨脑氧饱和度(SctO2)监测在冠心病患者行体外循环冠脉搭桥术中反映脑氧供需平衡的临床应用价值。方法 10例冠心病冠脉搭桥术患者,美国麻醉师协会(ASA)II^III级,术中常规监测动脉压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)、呼气末二氧化碳分压(PetCO2)、脑电双频指数(BIS)、体温(T)、SctO2。术中以SctO2为导向进行脑氧供需平衡管理。结果体外循环期间,SctO2明显下降(P<0.05),但高于基础值的75%,术后无认知功能障碍和严重神经系统并发症发生。结论体外循环冠脉搭桥术手术期间以SctO2为导向进行脑氧供需平衡管理,能够及时准确反映脑血流及氧供需平衡的变化,预防神经系统不良事件的发生。 Objective To investigate the value of cerebral tissue oxygen saturation ( SctO2 ) monitoring in clinical application for patients during coronary artery bypass grafting (CABG). Methods Ten patients with coronary artery disease, ASA II - III, were scheduled for CABG. Blood pressure (BP) , heart rate ( HR), pulse oxygen saturation ( SpO2 ), end - tidal carbon dioxide partial pressure ( PetCO2 ), bispectral index (BIS), body temperature (T) and SctO2 were monitored and recorded intraoperatively. During the operation, cerebral oxygen supply and demand balance was maintained by the guide of SctO2. Results During cardiopulmonary bypass, there was significant decrease of SctO2 ( P 〈 0.05 ), but SctO2 was not less than 75% of the basic value. There were no postoperative cognitive dysfunction or neurological complications after opera- tion. Conclusion SctO2 monitoring provides the real - time and accurate information of cerebral blood flow and cerebral oxygen balance and prevents neurological adverse events during CABG.
出处 《临床和实验医学杂志》 2014年第6期463-465,共3页 Journal of Clinical and Experimental Medicine
关键词 冠脉搭桥术 体外循环 脑氧饱和度 氧供需平衡 Coronary artery bypass grafting Cardiopulmonary bypass Cerebral tissue oxygen saturation Oxygen balance
  • 相关文献

参考文献10

  • 1Newman MF, Mathew JP, Grocott HP, et al. Central nervous system in- jury associated with cardiac surgery [ J ]. Lancet, 2006,368 ( 9536 ) : 694 - 703.
  • 2Fedorow C, Groeott HP. Cerebral monitoring to optimize outcomes after cardiac surgery[J]. Curr Opin Anaesthesiol, 2010,23 (1) :89 -94.
  • 3Vohra HA, Modi A, Ohri SK. Does use of intra - operative cerebral re- gional oxygen saturation monitoring during cardiac surgery lead to im- proved clinical outcomes[ J]. Interact Cardiovase Thorac Surg, 2009,9 (2) :318 -322.
  • 4Ito H, Ibaraki M, Kanno I, et al. Changes in the arterial fraction of hu- man cerebral blood volume during hypercapnia and hypoeapnia measured by positron emission tomography[ J]. J Cereb Blood Flow Metab, 2005, 25(7) :852 -857.
  • 5Smith M, Elwell C. Near - infrared spectroscopy : shedding light on the injured brain[J]. Anesth Analg, 2009,108(4) :1055 -1057.
  • 6Thavasothy M, Broadhead M, Elwell C, et al. A comparison of cerebral oxygenation as measured by the NIRO 300 and the INVOS 5100 Near - Infrared Spectrophntometers [ J ]. Anaesthesia, 2002,57 ( 10 ) : 999 - 1006.
  • 7Murkin JM, Adams SJ, Noviek RJ, et al. Monitoring brain oxygen satu- ration during coronary bypass surgery: a randomized, prospective study [ J]. Anesth Analg, 2007,104 ( 1 ) :51 - 58.
  • 8Casati A, Fanelli G, Pietropaoli P, et al. Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: a prospective cohort study [ J ]. Eur J Anaesthesiol, 2007,24 ( 1 ) : 59 - 65.
  • 9Casati A, Fanelli G, Pietropaoli P, et al. Continuous monitoring of cer- ebral oxygen saturation in elderly patients undergoing major abdominal surgery minimizes brain exposure to potential hypoxia [ J ]. Anesth Analg, 2005,101 (3) :740 -747.
  • 10Quarti A, Manfrini F, Oggianu A, et al. Non - invasive cerebral oxime- try monitoring during cardiopulmonary bypass incongenital cardiac sur- gery: a starting point[Jl. Perfusion, 2011,26(4) :289 -293.

同被引文献63

  • 1吴镜湘,沈耀峰,陈旭,章琪,徐美英.近红外光谱联合脑电双频谱指数监测在深低温停循环手术脑氧平衡监测中的应用[J].上海交通大学学报(医学版),2011,31(3):317-321. 被引量:4
  • 2李宝伟,米卫东,陈知进.脑氧饱和度监测用于颈部大动脉手术围术期管理[J].第四军医大学学报,2005,26(13):1206-1208. 被引量:6
  • 3高旭光.亚低温疗法的临床应用[J].中国全科医学,2005,8(22):1902-1902. 被引量:4
  • 4Miller RD//曾因明,邓小明主译.米勒麻醉学[M].6版.北京:北京大学医学出版社,2006:1646.
  • 5夏云.目前产科麻醉中的热点讨论[J].国际麻醉学与复苏杂志,2007,28(4):380-384. 被引量:45
  • 6Fedorow C, Grocott HP. Cerebral monitoring to optimize outcomes after cardiac snrgery[J]. Curr Opin Anaesthesiol, 2010, 23:89-94.
  • 7lto H, Ibaraki M, Kanno l, et al. Changes in the arterial fraction of human cerebral blood volume during hypereapnia and hypocapniameasured by positron emission tomography[J]. J Cereb Blood Flow Metab, 2005, 25:852-857.
  • 8()no M, Joshi B, Brady K, et al. Risks for impaired cerebral auloreg- ulation during cardiopulmonary bypass and postoperative stroke[J]. Br J Anaesth, 2012, 109:391-398.
  • 9Bartels K, McDonagh DL, Newman MF, et al. Neurncognilive out- comes after cardiac surgery[J]. Curt Opin Anaesthesiol, 2013, 26: 91-97.
  • 10Ghosh A, Elwell C, Smith M. Review arlicle: cerebral near-infrared spectroscopy in adults: a work in progress[J]. Anesth Analg, 2012, 115:1373-83.

引证文献8

二级引证文献34

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部