Related Experiment Video
Updated: May 31, 2026
04:20
Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
Published on: October 1, 2019
Cerebral oxygen desaturation during beach chair position
Annelies T Moerman1, Stefan G De Hert, Tom F Jacobs
1Department of Anaesthesiology, Ghent University Hospital, Ghent, Belgium. annelies.moerman@UGent.be
European Journal of Anaesthesiology
|July 7, 2011
Summary
Shoulder surgery in the beach chair position can cause significant cerebral oxygen desaturation in 80% of patients. Near-infrared spectroscopy (NIRS) can help detect this risk during anaesthesia.
Area of Science:
- Anesthesiology
- Neurosurgery
- Medical Monitoring
Background:
- Ischaemic brain damage is a risk in beach chair shoulder surgery.
- Routine anaesthesia monitoring may be insufficient to detect cerebral hypoperfusion.
- Near-infrared spectroscopy (NIRS) offers continuous, non-invasive monitoring of regional cerebral oxygen saturation (rScO2).
Purpose of the Study:
- Evaluate the prevalence of regional cerebral oxygen desaturation during shoulder surgery in the beach chair position.
- Identify factors contributing to cerebral desaturation in this patient group.
Main Methods:
- Prospective, observational, blinded study at a university hospital.
- Twenty adult patients undergoing elective shoulder surgery in the beach chair position.
- Routine anaesthesia management with blinded NIRS monitoring of rScO2.
Main Results:
- Significant decrease in rScO2 observed in 80% of patients upon adopting the beach chair position.
- Postural decreases in cerebral oxygenation correlated with blood pressure and end-tidal carbon dioxide levels.
- rScO2 dropped from baseline (approx. 78%) to ~58% on average post-positioning (P<0.001).
Conclusions:
- High prevalence of cerebral oxygen desaturation necessitates close monitoring during beach chair shoulder surgery.
- NIRS is a valuable tool for detecting cerebral hypoperfusion in this high-risk patient population.
Related Concept Videos
01:23Acute Respiratory Failure-IV
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
01:23Hypoxia
Hypoxia is a medical condition characterized by an inadequate oxygen supply to body tissues. It typically manifests as a bluish discoloration of the skin and mucosae, especially in fair-skinned individuals, when hemoglobin (Hb) saturation drops below 75%.
Types of Hypoxia
There are four primary types of hypoxia, each resulting from a different cause:
1. Anemic hypoxia: This type occurs due to insufficient oxygen delivery caused by a lack of red blood cells (RBCs) or RBCs with abnormal or...
Types of Hypoxia
There are four primary types of hypoxia, each resulting from a different cause:
1. Anemic hypoxia: This type occurs due to insufficient oxygen delivery caused by a lack of red blood cells (RBCs) or RBCs with abnormal or...
01:25Hyperpnea and Hyperventilation
Hyperventilation refers to a higher-than-normal rate and depth of breathing, often associated with anxiety attacks. This excessive breathing surpasses the body's need to expel CO2, leading to a condition known as hypocapnia - an unusually low level of carbon dioxide in the blood. Hypocapnia can constrict cerebral blood vessels, reducing blood flow to the brain, which may result in dizziness or fainting. Early signs include tingling and muscle spasms in the hands and face, caused by falling...
01:19Special considerations while measuring oxygen saturation
Assessing respiratory rate concurrently with pulse measurement is fundamental to patient care, providing valuable insights into the patient's respiratory function. The normal breathing rate for an adult usually falls within a normal range of 12 to 20 breaths per minute. Abnormal respiratory rates can signal underlying health conditions or the need for immediate intervention.
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is important.
Ensuring accuracy in vital sign recordings while prioritizing patient comfort and minimizing anxiety is important.
01:30Alterations in Respiration II
There are numerous types of normal and abnormal respiration. Based on ventilatory movements, breathing patterns are classified as regular, deep, or shallow. Examples include Biot's breathing, Cheyne-Stokes respiration, Kussmaul's breathing, hyperventilation, and hypoventilation. Each pattern is clinically significant and aids in evaluating patients.
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
In Biot's breathing, the respiratory rate and depth are irregular, alternating between periods of deep gasping and apnea. Common causes include...
01:21Acute Respiratory Failure-II
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include: