Monitoring regional cerebral oxygen saturation using near-infrared spectroscopy during pulsatile hypothermic cardiopulmonary bypass in a neonatal piglet model

Akif Undar, Harald C. Eichstaedt, O. H. Frazier, Charles D. Fraser

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Impairment of cerebral oxygenation in neonates and infants after hypothermic nonpulsatile cardiopulmonary bypass (CPB) support is well documented. The objectives of this study were: 1) using a neonatal piglet model to continuously monitor the regional cerebral oxygen saturation (rSO2) by near-infrared spectroscopy during pulsatile hypothermic CPB; and 2) to quantify the pulsatile flow in terms of energy equivalent pressure (EEP). After initiation of CPB, all piglets (n = 5) were subjected to 15 minutes of core cooling, reducing the rectal temperature to 25 °C, followed by 60 minutes of hypothermic CPB, then 10 minutes of cold reperfusion, and 30 minutes of rewarming. During CPB, mean arterial pressures (MAPs) and pump flow rates were maintained at 40-45 mm Hg and 150 ml/kg/min, respectively. During normothermic CPB, the rSO2 was significantly increased, compared with the pre-CPB level (56.8±5.2% vs. 41.8±5.5%, p<0.01). At the end of cooling, the rSO2 level was 76.8±8.6% (p<0.001 vs. pre-CPB). After 60 minutes of hypothermic CPB and 30 minutes of rewarming, the rSO2 level was decreased to 38.6±4.2%, which was not significantly different compared with the pre-CPB level. The average increase in pressure (from MAP to EEP) was 5±1%, and the average increase in extracorporeal circuit pressure (from ECCP to EEP) was 13±2%. This extra pressure may help to provide better regional cerebral oxygen saturation. During pulsatile CPB, there was no rSO2 deficiency in this high flow model. Near-infrared spectroscopy responded well to changes in rSO2 during different stages of these experiments and might be a helpful tool for intraoperative monitoring.

Original languageEnglish (US)
Pages (from-to)103-106
Number of pages4
JournalASAIO Journal
Volume46
Issue number1
DOIs
StatePublished - Jan 1 2000

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Near infrared spectroscopy
Near-Infrared Spectroscopy
Cardiopulmonary Bypass
Oxygen
Monitoring
Pressure
Rewarming
Cooling
Pulsatile flow
Arterial Pressure
Oxygenation
Intraoperative Monitoring
Pulsatile Flow
Flow rate
Pumps
Reperfusion
Networks (circuits)
Newborn Infant

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

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title = "Monitoring regional cerebral oxygen saturation using near-infrared spectroscopy during pulsatile hypothermic cardiopulmonary bypass in a neonatal piglet model",
abstract = "Impairment of cerebral oxygenation in neonates and infants after hypothermic nonpulsatile cardiopulmonary bypass (CPB) support is well documented. The objectives of this study were: 1) using a neonatal piglet model to continuously monitor the regional cerebral oxygen saturation (rSO2) by near-infrared spectroscopy during pulsatile hypothermic CPB; and 2) to quantify the pulsatile flow in terms of energy equivalent pressure (EEP). After initiation of CPB, all piglets (n = 5) were subjected to 15 minutes of core cooling, reducing the rectal temperature to 25 °C, followed by 60 minutes of hypothermic CPB, then 10 minutes of cold reperfusion, and 30 minutes of rewarming. During CPB, mean arterial pressures (MAPs) and pump flow rates were maintained at 40-45 mm Hg and 150 ml/kg/min, respectively. During normothermic CPB, the rSO2 was significantly increased, compared with the pre-CPB level (56.8±5.2{\%} vs. 41.8±5.5{\%}, p<0.01). At the end of cooling, the rSO2 level was 76.8±8.6{\%} (p<0.001 vs. pre-CPB). After 60 minutes of hypothermic CPB and 30 minutes of rewarming, the rSO2 level was decreased to 38.6±4.2{\%}, which was not significantly different compared with the pre-CPB level. The average increase in pressure (from MAP to EEP) was 5±1{\%}, and the average increase in extracorporeal circuit pressure (from ECCP to EEP) was 13±2{\%}. This extra pressure may help to provide better regional cerebral oxygen saturation. During pulsatile CPB, there was no rSO2 deficiency in this high flow model. Near-infrared spectroscopy responded well to changes in rSO2 during different stages of these experiments and might be a helpful tool for intraoperative monitoring.",
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Monitoring regional cerebral oxygen saturation using near-infrared spectroscopy during pulsatile hypothermic cardiopulmonary bypass in a neonatal piglet model. / Undar, Akif; Eichstaedt, Harald C.; Frazier, O. H.; Fraser, Charles D.

In: ASAIO Journal, Vol. 46, No. 1, 01.01.2000, p. 103-106.

Research output: Contribution to journalArticle

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AB - Impairment of cerebral oxygenation in neonates and infants after hypothermic nonpulsatile cardiopulmonary bypass (CPB) support is well documented. The objectives of this study were: 1) using a neonatal piglet model to continuously monitor the regional cerebral oxygen saturation (rSO2) by near-infrared spectroscopy during pulsatile hypothermic CPB; and 2) to quantify the pulsatile flow in terms of energy equivalent pressure (EEP). After initiation of CPB, all piglets (n = 5) were subjected to 15 minutes of core cooling, reducing the rectal temperature to 25 °C, followed by 60 minutes of hypothermic CPB, then 10 minutes of cold reperfusion, and 30 minutes of rewarming. During CPB, mean arterial pressures (MAPs) and pump flow rates were maintained at 40-45 mm Hg and 150 ml/kg/min, respectively. During normothermic CPB, the rSO2 was significantly increased, compared with the pre-CPB level (56.8±5.2% vs. 41.8±5.5%, p<0.01). At the end of cooling, the rSO2 level was 76.8±8.6% (p<0.001 vs. pre-CPB). After 60 minutes of hypothermic CPB and 30 minutes of rewarming, the rSO2 level was decreased to 38.6±4.2%, which was not significantly different compared with the pre-CPB level. The average increase in pressure (from MAP to EEP) was 5±1%, and the average increase in extracorporeal circuit pressure (from ECCP to EEP) was 13±2%. This extra pressure may help to provide better regional cerebral oxygen saturation. During pulsatile CPB, there was no rSO2 deficiency in this high flow model. Near-infrared spectroscopy responded well to changes in rSO2 during different stages of these experiments and might be a helpful tool for intraoperative monitoring.

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