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Rabie A, Abdou MS. Near infrared spectroscopy and abdominal compartmental syndrome in neonates. EGYPTIAN JOURNAL OF ANAESTHESIA 2021. [DOI: 10.1080/11101849.2021.1979339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Aliaa Rabie
- Lecturer of Anesthesia and Surgical Intensive Care, Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Marwa Shawky Abdou
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Egypt
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Liu L, Qiang Z, Zhang J, Ren Y, Zhao X, Fu W, Xin Z, Xu Z, Wang F, Li L, Zou N, Zhang X, Feng L, Ma S. Effect of hemoglobin content on cerebral oxygen saturation during surgery for scoliosis in pediatric patients. BMC Anesthesiol 2021; 21:165. [PMID: 34074238 PMCID: PMC8167970 DOI: 10.1186/s12871-021-01382-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 05/13/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Although regional cerebral oxygen saturation (rScO2) monitoring has been widely used in clinical practice, the relationship between hemoglobin (dHB) content and rScO2 is incompletely understood. The aim of this study was to analyze the effect of hemoglobin content on rScO2 in pediatric patients undergoing general anesthesia for correction of scoliosis. METHODS Ninety-two pediatric patients aged 3 to 14 years undergoing scoliosis correction surgery were enrolled. Continuous monitoring of bilateral regional cerebral oxygen saturation by near-infrared spectroscopy (NIRS, CASMED, USA) was performed after entering the operation room. rScO2 was recorded when the patients entered the operating room (T0, baseline), after anesthesia induced intubation (T1), and after radial artery puncture (T2). The lowest value of rScO2 during surgery was also recorded. The arterial blood pressure (ABP), heart rate (HR), pulse oxygen saturation (SpO2), end tidal carbon dioxide partial pressure (PetCO2) were continuously recorded. Patients were classified as low rScO2 or high rScO2 group according to whether the lowest intraoperative rScO2 was 15% lower than the baseline value. An analysis and comparison of differences in hemoglobin content in these two groups was carried out. RESULTS The preoperative hemoglobin-postoperative hemoglobin of patients in the high rScO2 group was significantly lower than that in the low rScO2 group (t = - 7.86, p < 0.01), the amount of bleeding during the operation was also less than that in the low rScO2 group (t = - 6.05, p < 0.01), and the systolic pressure of patients was higher than that in the low rScO2 group (t = 4.27, p < 0.01). CONCLUSIONS The decrease in hemoglobin level which occurs during surgery leads to a decrease in cerebral oxygen saturation. In order to ensure patient safety during surgery, it is necessary to carry out volume management and appropriate transfusion and fluid replacement in a timely manner. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR1800016359 . Registered 28 May 2018.
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Affiliation(s)
- Lin Liu
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhipeng Qiang
- Department of Anesthesiology, Jining NO.1 People's Hospital, Jining Medical University, Jining, Shandong, China
| | - Jianmin Zhang
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Yi Ren
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xin Zhao
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Wenya Fu
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhong Xin
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zenghua Xu
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Fang Wang
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lijing Li
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Nan Zou
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xuemei Zhang
- Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Lei Feng
- Department of Orthopedics, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shuxuan Ma
- Department of Transfusion Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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Beck J, Loron G, Masson C, Poli-Merol ML, Guyot E, Guillot C, Bednarek N, François C. Monitoring Cerebral and Renal Oxygenation Status during Neonatal Digestive Surgeries Using Near Infrared Spectroscopy. Front Pediatr 2017; 5:140. [PMID: 28660179 PMCID: PMC5469885 DOI: 10.3389/fped.2017.00140] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 06/01/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Depending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS) is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause. OBJECTIVE Evaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters. Analyzing retrospectively the inter-relationships between NIRS values and mean arterial pressure (MAP) values as well as pre-ductal SpO2. METHODS Prospective, descriptive, monocentric study. All neonates referred for surgery were included. NIRS allows the measurement of cerebral and renal oxygenation fluctuations, as well as calculating difference in intraoperative and postoperative values. RESULTS Nineteen patients were included. Cerebral regional oxygen saturation (C rSO2) values were stable while renal regional oxygen saturation (R rSO2) values tended to decrease with time during surgery. Indeed, 72% of rSO2 decline episodes occurred after the first 30 min of surgery, without any significant statistical differences for the next 90 min of surgery. After surgery, the lowest average C and R rSO2 values were evidenced during the first 6 h, with 60% of C rSO2 and R rSO2 anomalies occurring in that time frame. There was no significant statistical difference observed in the following 18 h. There was a significant correlation between R rSO2 and SpO2 values (p < 0.01), but not with C rSO2 values. There was no correlation with the MAP either for the C rSO2 values or R rSO2 ones. CONCLUSION NIRS is a promising non-invasive bedside tool to monitor cerebral and tissue perfusion, analyzing tissue microcirculation. NIRS has its interest to guide neonatal digestive surgeries (bowel manipulation, viscera reduction) and may represent an early warning for identifying patients requiring resuscitation during or after these surgeries.
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Affiliation(s)
- Jonathan Beck
- Neonatal and Pediatric Intensive Care Unit, CHU of Reims American Memorial Hospital, Reims, France
| | - Gauthier Loron
- Neonatal and Pediatric Intensive Care Unit, CHU of Reims American Memorial Hospital, Reims, France
| | - Claire Masson
- Department of Research and Public Health, CHU of Reims, Reims, France
| | - Marie-Laurence Poli-Merol
- Department of Pediatric Surgery, CHU of Reims Hôpital Maison Blanche, Reims, France.,University of Reims Champagne Ardennes, UFR médecine, Reims, France
| | - Eliane Guyot
- Department of Pediatric Anesthesia, CHU of Reims Hôpital Maison Blanche, Reims, France
| | | | - Nathalie Bednarek
- Neonatal and Pediatric Intensive Care Unit, CHU of Reims American Memorial Hospital, Reims, France.,University of Reims Champagne Ardennes, UFR médecine, Reims, France
| | - Caroline François
- Plastic Reconstructive Surgery and Anesthesiology, CHU of Reims Hôpital Maison Blanche, Reims, France.,EA 3801 Laboratory, Champagne Ardennes University SFR CAP santé Reims-Amiens, UFR médecine, Reims, France
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Williams M, Lee JK. Intraoperative blood pressure and cerebral perfusion: strategies to clarify hemodynamic goals. Paediatr Anaesth 2014; 24:657-67. [PMID: 24725244 PMCID: PMC4154320 DOI: 10.1111/pan.12401] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2014] [Indexed: 01/24/2023]
Abstract
Blood pressure can vary considerably during anesthesia. If blood pressure falls outside the limits of cerebrovascular autoregulation, children can become at risk of cerebral ischemic or hyperemic injury. However, the blood pressure limits of autoregulation are unclear in infants and children, and these limits can shift after brain injury. This article will review autoregulation, considerations for the hemodynamic management of children with brain injuries, and research on autoregulation monitoring techniques.
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Affiliation(s)
- Monica Williams
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, USA
| | - Jennifer K. Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, USA
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