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[Not Available].
Joseph D Tobias1, Garry A Johnson, Saif Rehman
1Department of Anaesthesiology University of Missouri, Columbia, Missouri.
Journal of Minimal Access Surgery
|June 24, 2009
Summary
Significant changes in cerebral oxygenation (rSO2) occur during one-lung ventilation (OLV). Further research is needed to understand the impact of these cerebral oxygenation changes on patient outcomes after thoracic surgery.
Area of Science:
- Anesthesiology
- Neurosurgery
- Thoracic Surgery
Background:
- One-lung ventilation (OLV) is a common practice during thoracic surgery.
- OLV can lead to changes in systemic oxygenation due to intrapulmonary shunt.
- The impact of these oxygenation changes on cerebral oxygenation during OLV is not well-studied.
Purpose of the Study:
- To prospectively monitor and evaluate changes in cerebral oxygenation during OLV in adult patients.
- To investigate the relationship between systemic oxygenation and cerebral oxygenation during OLV.
- To identify patient factors associated with significant drops in cerebral oxygenation during OLV.
Main Methods:
- Cerebral oxygenation (rSO2) was monitored using near-infrared spectroscopy in 40 adult patients undergoing OLV.
- Systemic parameters including heart rate, blood pressure, SaO2, and ETCO2 were also monitored.
- No clinical decisions were based on rSO2 values; inspired oxygen was adjusted to maintain SaO2 >/= 95%.
Main Results:
- Over 18,000 rSO2 values were collected, revealing significant variability.
- 19% of rSO2 readings were at or above baseline, while 38% were 1-9% below baseline.
- 14% of all rSO2 values were less than 75% of baseline, with 20% of patients experiencing prolonged drops.
Conclusions:
- Thoracic surgical procedures involving OLV are associated with significant, variable changes in cerebral oxygenation (rSO2).
- A subset of patients experienced substantial and prolonged decreases in rSO2.
- Further investigation is warranted to determine the clinical significance of these rSO2 changes on postoperative outcomes.
