TY - JOUR
T1 - Esophageal saturation during antegrade cerebral perfusion
T2 - A preliminary report using visible light spectroscopy
AU - Heninger, Carly
AU - Ramamoorthy, Chandra
AU - Amir, Gabriel
AU - Kamra, Komal
AU - Reddy, V. Mohan
AU - Hanley, Frank L.
AU - Brock-Utne, John G.
PY - 2006/11
Y1 - 2006/11
N2 - Background: Visible light spectroscopy (VLS) is newer technology that measures real-time tissue oxygenation. It has been validated in detecting mucosal ischemia in adults. During complex neonatal heart surgery, antegrade cerebral perfusion (ACP) maintains cerebral saturation. Whether ACP maintains peripheral tissue perfusion in humans is not known. Methods: Five patients undergoing neonatal open heart surgery with hypothermic cardiopulmonary bypass (CPB) were studied using a VLS esophageal probe in addition to bilateral near infrared cerebral oximetry. Three of five patients required ACP for arch repair, while two patients did not. VLS and cerebral saturation data were collected and analyzed in 5 min intervals prior to CPB, during CPB, and during ACP. Results: In the two patients undergoing heart surgery with routine hypothermic CPB, both cerebral and esophageal saturations were maintained. However in all three neonates requiring ACP, although cerebral saturations did not decrease, esophageal saturation fell below the ischemic threshold (35%). Following establishment of normal CPB, esophageal saturation returned to baseline. Conclusions: Antegrade cerebral perfusion maintains cerebral oxygen delivery, however, it does not adequately perfuse the esophagus in neonates. This could have clinical implications.
AB - Background: Visible light spectroscopy (VLS) is newer technology that measures real-time tissue oxygenation. It has been validated in detecting mucosal ischemia in adults. During complex neonatal heart surgery, antegrade cerebral perfusion (ACP) maintains cerebral saturation. Whether ACP maintains peripheral tissue perfusion in humans is not known. Methods: Five patients undergoing neonatal open heart surgery with hypothermic cardiopulmonary bypass (CPB) were studied using a VLS esophageal probe in addition to bilateral near infrared cerebral oximetry. Three of five patients required ACP for arch repair, while two patients did not. VLS and cerebral saturation data were collected and analyzed in 5 min intervals prior to CPB, during CPB, and during ACP. Results: In the two patients undergoing heart surgery with routine hypothermic CPB, both cerebral and esophageal saturations were maintained. However in all three neonates requiring ACP, although cerebral saturations did not decrease, esophageal saturation fell below the ischemic threshold (35%). Following establishment of normal CPB, esophageal saturation returned to baseline. Conclusions: Antegrade cerebral perfusion maintains cerebral oxygen delivery, however, it does not adequately perfuse the esophagus in neonates. This could have clinical implications.
KW - Cardiopulmonary bypass
KW - Children: somatic perfusion
KW - Near infrared cerebral oximetry
KW - Open heart surgery
KW - Visible light spectroscopy
UR - http://www.scopus.com/inward/record.url?scp=33750072279&partnerID=8YFLogxK
U2 - 10.1111/j.1460-9592.2006.01965.x
DO - 10.1111/j.1460-9592.2006.01965.x
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C2 - 17040301
AN - SCOPUS:33750072279
SN - 1155-5645
VL - 16
SP - 1133
EP - 1137
JO - Paediatric Anaesthesia
JF - Paediatric Anaesthesia
IS - 11
ER -
