Top

Published in:

Open Access 01-12-2008 | Research article

Higher cerebral oxygen saturation may provide higher urinary output during continuous regional cerebral perfusion

Authors: Takashi Miyamoto, Kagami Miyaji, Hirotsugu Okamoto, Satoshi Kohira, Takahiro Tomoyasu, Nobuyuki Inoue, Kuniyoshi Ohara

Published in: Journal of Cardiothoracic Surgery | Issue 1/2008

Abstract

Objective

We examined the hypothesis that higher cerebral oxygen saturation (rSO₂) during RCP is correlated with urinary output.

Methods

Between December 2002 and August 2006, 12 patients aged 3 to 61 days and weighing 2.6 to 3.4 kg underwent aortic arch repair with RCP. Urinary output and rSO₂ were analyzed retrospectively. Data were assigned to either of 2 groups according to their corresponding rSO₂: Group A (rSO₂ ≦ 75%) and Group B (rSO₂ < 75%).

Results

Seven and 5 patients were assigned to Group A and Group B, respectively.

Group A was characterized by mean radial arterial pressure (37.9 ± 9.6 vs 45.8 ± 7.8 mmHg; P = 0.14) and femoral arterial pressure (6.7 ± 6.1 vs 20.8 ± 14.6 mmHg; P = 0.09) compared to Group B. However, higher urinary output during CPB (1.03 ± 1.18 vs 0.10 ± 0.15 ml·kg^-1·h^-1; P = 0.03). Furthermore our results indicate that a higher dose of Chlorpromazine was used in Group A (2.9 ± 1.4 vs 1.7 ± 1.0 mg/kg; P = 0.03).

Conclusion

Higher cerebral oxygenation may provide higher urinary output due to higher renal blood flow through collateral circulation.

Available only for authorised users

Asfour B, Fink C, Sinzobahamvya N, Wetter J, Urban AE, Photiadis J: Modified children's II operation on beating heart allows growth potential. Ann Thorac Surg. 2005, 80: e14-6. 10.1016/j.athoracsur.2005.05.074.CrossRefPubMed

Stasik CN, Goldberg CS, Bove EL, Devaney EJ, Ohye RG: Current outcomes and risk factors for the Norwood procedure. J Thorac Cardiovasc Surg. 2006, 131: 412-7. 10.1016/j.jtcvs.2005.09.030.CrossRefPubMed

Pigula FA, Nemoto EM, Griffith BP, Siewers RD: Regional low-flow perfusion provides cerebral circulatory support during neonatal aortic arch reconstruction. J Thorac Cardiovasc Surg. 2000, 119: 331-9. 10.1016/S0022-5223(00)70189-9.CrossRefPubMed

Andropoulos DB, Stayer SA, McKenzie ED, Fraser CD: Novel cerebral physiologic monitoring to guide low-flow cerebral perfusion during neonatal aortic arch reconstruction. J Thorac Cardiovasc Surg. 2003, 125: 491-9. 10.1067/mtc.2003.159.CrossRefPubMed

Wahr JA, Tremper KK, Samra S, Delpy DT: Near-Infrared Spectroscopy: Theory and Applications. J Cardiothorac Vasc Anesth. 1996, 10 (3): 406-418. 10.1016/S1053-0770(96)80107-8.CrossRefPubMed

Roerick O, Seitz T, Mauser-Weber P, Palmaers T, Weyand M, Cesnjevar R: Low-flow perfusion via the innominate artery during aortic arch operations provides only limited somatic circulatory support. Eur J Cardiothorac Surg. 2006, 29: 517-24. 10.1016/j.ejcts.2005.12.048.CrossRefPubMed

Oppido G, Napoleone CP, Turci S, Davies Ben, Frascaroli G, Martin-Suarez S, Giardini A, Gargiulo G: Moderately hypothermic cardiopulmonary bypass and low-flow antegrade selective cerebral perfusion for neonatal aortic arch surgery. Ann Thorac Surg. 2006, 82: 2233-2239. 10.1016/j.athoracsur.2006.06.042.CrossRefPubMed

Pigula FA, Gandhi SK, Siewers RD, Davis PJ, Webber SA, Nemoto EM: Regional low-flow perfusion provides somatic circulatory support during neonatal aortic arch surgery. Ann Thorac Surg. 2001, 72: 401-7. 10.1016/S0003-4975(01)02727-8.CrossRefPubMed

Andropoulos DB, Stayer SA, McKenzie ED, Fraser CD: Regional low-flow perfusion provides comparable blood flow and oxygenation to both cerebral hemispheres during neonatal aortic reconstruction. J Thorac Cardiovasc Surg. 2003, 126: 1712-7. 10.1016/S0022-5223(03)01027-4.CrossRefPubMed

10.

Hoffman GM, Stuth EA, Jaquiss RD, Vanderwal PL, Staudt SR, Troshynski TJ, Ghanayem NS, Tweddell JS: Changes in cerebral and somatic oxygenation during stage 1 palliation of hypoplastic left heart syndrome using continuous regional cerebral perfusion. J Thorac Cardiovasc Surg. 2004, 127: 223-33. 10.1016/j.jtcvs.2003.08.021.CrossRefPubMed

11.

Hoffman GM, Mussatto KA, Brosig CL, Ghanayem NS, Musa N, Fedderly RT, Jaquiss RDB, Tweddell JS: Systemic venous oxygen saturation after the Norwood procedure and chinldhood neurodevelopmental outcome. J Thorac Cardiovasc Surg. 2005, 130: 1094-100. 10.1016/j.jtcvs.2005.06.029.CrossRefPubMed

12.

Levy WJ, Levin S, Chance B: Near-infrared measurement of cerebral oxygenation. Correlation with electroencephalographic ischemia during ventricular fibrillation. Anesthesiology. 1995, 83: 738-46. 10.1097/00000542-199510000-00013.CrossRefPubMed

13.

Kurth CD, Levy WJ, McCann J: Near-infrared spectroscopy cerebral oxygen saturation thresholds for hypoxia-ischemia in piglets. J Cereb Blood Floe Metab. 2002, 22: 335-41. 10.1097/00004647-200203000-00011.CrossRef

14.

Nakano T, Kado H, Shiokawa Y, Fukae K, Nishimura Y, Miyamoto K, Tanoue Y, Tatewaki H, Fusazaki N: The low resistance strategy for the perioperative management of the Norwood procedure. Ann Thorac Surg. 2004, 77: 908-12. 10.1016/j.athoracsur.2003.09.025.CrossRefPubMed

15.

Imoto Y, Kado H, Shiokawa Y, Minami K, Yasui H: Experience with the Norwood procedure without circulatory arrest. J Thorac Cardiovasc Surg. 2001, 122: 879-82. 10.1067/mtc.2001.116948.CrossRefPubMed

16.

Azakie A, Muse J, Gardner M, Skidmore KL, Miller SP, Karl TR, McQuillen PS: Cerebral oxygen balance is impaired during repair of aortic coarctation in infants and children. J Thorac Cardiovasc Surg. 2005, 130: 830-6. 10.1016/j.jtcvs.2005.04.015.CrossRefPubMed

17.

Newburger JW, Jonas RA, Wernovsky G, Wypij D, Hickey PR, Kuban KC, Farrell DM, Holmes GL, Helmers SL, Constantinou J, Carrazana E, Barlow JK, Walsh AZ, Lucius WK, Share JC, Wessel DL, Hanley FL, Mayer JE, Castaneda AR, Ware JH: A comparison of the perioperative neurologic effects of hypothermic circulatory arrest versus low-flow cardiopulmonary bypass in infant heart surgery. N Engl J Med. 1994, 330: 716-717. 10.1056/NEJM199403103301016.CrossRef

Title: Higher cerebral oxygen saturation may provide higher urinary output during continuous regional cerebral perfusion
Authors: Takashi Miyamoto
Kagami Miyaji
Hirotsugu Okamoto
Satoshi Kohira
Takahiro Tomoyasu
Nobuyuki Inoue
Kuniyoshi Ohara
Publication date: 01-12-2008
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2008
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/1749-8090-3-58

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Higher cerebral oxygen saturation may provide higher urinary output during continuous regional cerebral perfusion

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2008

Large asymptomatic Left Atrial Myxoma with ossification: case report

Aberrant right subclavian artery and calcified aneurysm of kommerell's diverticulum: an alternative approach

Cardiac Valvular Inflammatory Pseudotumor

Interventional bronchoscopy for benign tracheobronchial diseases under cardiopulmonary bypass support: case reports and literature review

Cardiac retransplantation is an efficacious therapy for primary cardiac allograft failure

Contegra conduit for reconstruction of the right ventricular outflow tract: a review of published early and mid-time results