Cerebral oximetry and stump pressure as indicators for shunting during carotid endarterectomy: comparative evaluation (Journal article)
Tambakis, C. L./ Papadopoulos, G./ Sergentanis, T. N./ Lagos, N./ Arnaoutoglou, E./ Labropoulos, N./ Matsagkas, M. I.
The purpose of this work is to investigate the correlation between regional oxygen saturation (rSO(2)) changes and stump pressure (SP) during cross-clamping of the internal carotid artery in carotid endarterectomy (CEA) and verify the perspectives of rSO(2) to become a criterion for shunting. Sixty consecutive CEAs under general anesthesia were studied prospectively. Selective shunting was based on SP =40 mmHg exclusively. Regression analysis with high order terms and receiver operating characteristic analysis were performed to investigate the association between DeltarSO(2)(%) and SP and to determine an optimal DeltarSO(2)(%) threshold for shunt insertion. A quadratic association between DeltarSO(2)(%) and SP was documented regarding the baseline to one and five minutes after cross-clamping intervals. A cut-off of 21 and 10.1% reduction from the baseline recording was identified as optimal for the distinction between patients needed or not a shunt regarding the first and fifth minute after cross-clamping, respectively. In conclusion, cerebral oximety reflects sufficiently cerebral oxygenation during CEA compared with SP, providing a useful mean for cerebral monitoring.
|Institution and School/Department of submitter:||Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής|
|Keywords:||Adult,Aged,Aged, 80 and over,Biological Markers/blood,*Blood Pressure,*Blood Pressure Determination,Carotid Artery Diseases/blood/diagnosis/physiopathology/*surgery,Carotid Artery, Internal/physiopathology/*surgery,*Cerebrovascular Circulation,Constriction,*Endarterectomy, Carotid/adverse effects,Female,Greece,Humans,Male,Middle Aged,Monitoring, Intraoperative/*methods,*Oximetry,Oxygen/*blood,Predictive Value of Tests,Prospective Studies,ROC Curve,Regression Analysis,*Spectroscopy, Near-Infrared,Treatment Outcome|
|Appears in Collections:||Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)|
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