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Titolo:
Monitoring of antegrade selective cerebral perfusion for aortic arch surgery with transcranial Doppler ultrasonography and near-infrared spectroscopy
Autore:
Yu, QJ; Sun, LZ; Chang, Q; Sun, GM; Liu, J;
Indirizzi:
Fu Wai Hosp, Dept Anesthesiol, Beijing 100037, Peoples R China Fu Wai Hosp Beijing Peoples R China 100037 ijing 100037, Peoples R China Fu Wai Hosp, Dept Surg, Beijing 100037, Peoples R China Fu Wai Hosp Beijing Peoples R China 100037 ijing 100037, Peoples R China Chinese Acad Med Sci, Cardiovasc Inst, Beijing 100037, Peoples R China Chinese Acad Med Sci Beijing Peoples R China 100037 037, Peoples R China Peking Union Med Coll, Beijing 100037, Peoples R China Peking Union Med Coll Beijing Peoples R China 100037 37, Peoples R China
Titolo Testata:
CHINESE MEDICAL JOURNAL
fascicolo: 3, volume: 114, anno: 2001,
pagine: 257 - 261
SICI:
0366-6999(200103)114:3<257:MOASCP>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
HYPOTHERMIC CIRCULATORY ARREST;
Keywords:
transcranial Doppler ultrasonography; near-infrared spectroscopy; antegrade selective cerebral perfusion; aortic surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
11
Recensione:
Indirizzi per estratti:
Indirizzo: Yu, QJ Fu Wai Hosp, Dept Anesthesiol, Beijing 100037, Peoples R China Fu Wai Hosp Beijing Peoples R China 100037 00037, Peoples R China
Citazione:
Q.J. Yu et al., "Monitoring of antegrade selective cerebral perfusion for aortic arch surgery with transcranial Doppler ultrasonography and near-infrared spectroscopy", CHIN MED J, 114(3), 2001, pp. 257-261

Abstract

Objective To evaluate the safety and efficacy of antegrade selective cerebral perfusion (ASCP) during aortic arch surgery as a means of extending thesafe period of systemic circulatory arrest using multimodality neuromonitoring to objectively quantify the physiologic responses. Methods In twenty-two patients (all less than age 60) scheduled for repairof an aortic arch aneurysm, preoperative verification of effective collateral perfusion through both the carotid and vertebrobasillar arterial systems was documented with transcranial Doppler ultrasonography (TCD). During cardiopulmonary bypass, the sole arterial inflow,from the pump was via the right subclavian artery. The magnitude of ASCP was quantified by TCD using peak middle cerebral artery velocity, while flow adequacy was measured by continuous regional cerebrovenous oxygen saturation (rSO(2)) using dual-wavelength spatially resolved near-infrared spectroscopy. Results All patients experienced an uneventful recovery. Flow in the middle cerebral artery became undetectable at ASCP < 5 ml.kg(-1).min(-1), so adjustments from a 15-20 ml.kg(-1).min(-1) baseline were used to maintain rSO(2) above 50%. Furthermore, ASCP flow was highly correlated (P < 0.01) with both peak middle cerebral artery velocity and rSO(2) (r = 0.86 and 0.96, respectively). Conclusion Neuromonitoring guided ASCP may be expected to extend the safe period and is at least partly responsible for the absence of neurologic complications in this patient cohort.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 09:08:52