Naslov
High inspired oxygen concentration may reduce brain hypoxia in the patients undergoing carotid endarterectomy with total intravenous anaesthesia

Autori
Kvolik, Slavica ; Gašić, Vedran ; Pinotić, Krešimir ; Istvanic, Tomislav ; Flam, Damir ; Bilandzic, Davor.

Izvornik
European Journal of Anaesthesiology

Vrsta, podvrsta
Ostale vrste radova, ostalo

Godina
2016

Ključne riječi
Carotid endarterectomy; Neuromonitoring; Brain tissue oxygenation; Total intravenous anesthesia

Sažetak
High inspired oxygen concentration may reduce brain hypoxia in the patients undergoing carotid endarterectomy with total intravenous anaesthesia Background. High inspired oxygen concentrations may improve cerebral tissue oxygenation in the patents undergoing carotid endarterectomy (CE). However, there are some studies suggesting that high inspired oxygen concentration may induce cerebral vasoconstriction. This study was performed to measure the influence of FiO2 on the regional tissue oxygenation (rSO2) in the patients undergoing CEA with total intravenous anaesthesia (TIVA). Methods. After ethics committee approval and patients’ written informed consent were obtained, 28 patients undergoing elective CE were randomized to receive TIVA with 35% inspired O2 (group A) or TIVA 100% O2 (Group B). The INVOS 5100B monitor was used for rSO2 measurement from operative and nonoperative side, and INVOS Analytics Tool (Covidien) for AUC calculations. A bispectral index and invasive blood pressure monitoring were used in all patients. Data were analysed using two sided T-test and Fisher exact test. A P<0.05 was considered as statistically significant. Results. The mean patients’ age was 66.3±13.1 in A and 68.4±6.7 years in B group. Baseline rSO2 were not different between two groups. The maximal intraoperative rSO2 decrease on the operative side after the head reposition and/or carotid cross clamping was 37.1±15.8 in A and 23.1±11.9 in B group (P=0.05). The mean AUC for rSO2 decrease was 143.6±186 in A and 37.6±67.5 in B group respectively (P=0.002). The rSO2 decreased significantly from baseline at the skin closure point in A group (72.2 vs. 65.8, P=0.022), and was unchanged in group B (64.9 vs. 67.1). Intraoperative shunt was placed in 3 patients in A and in 1 in B group (P=0.592). Conclusion. Intraoperative high oxygen concentrations may reduce intensity of tissue hypoxic episodes during CE in TIVA. Postoperative follow up in large patient’s group is necessary to confirm its impact on patients’ outcome.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA