체외순환 없는 관상동맥우회술을 시행 받는 환자에서 국소 뇌산소 포화도와 경정맥구 산소포화도의 비교 (Comparison between Regional Cerebral Oxygen Saturation and Jugular Bulb Venous Oxygen Saturation in Patients Undergoing OPCAB Surgery)

서지정보

· 발행기관 : 대한마취통증의학회
· 수록지 정보 : Korean Journal of Anesthesiology / 54권 / 1호 / 47 ~ 52페이지
· 저자명 : 이은호, 하승일, 조민수, 정용보, 함경돈, 이윤경, 최인철

초록

Hypoperfusion during manipulation of the heart in off-pump coronary artery bypass (OPCAB) surgery may lead to postoperative neurological complications. Therefore, it will be necessary to monitor cerebral function during OPCAB surgery. In this study, we compared regional cerebral oxygenation (rSO2) by near-infrared spectroscopy (NIRS) with jugular bulb venous oxygen saturation (SjvO2) and assessed whether rSO2 measured by NIRS could be an alternative method of SjvO2 during OPCAB surgery.
Methods: A total of 20 patients who underwent OPCAB surgery were studied. A fiberoptic catheter was placed in the right jugular bulb to measure SjvO2 while a cerebral oximeter based on NIRS, INVOS 5100B was used to monitor rSO2. Radial arterial and jugular bulb blood samples were drawn simultaneously from baseline every hour during operation. The values of rSO2 were compared with SjvO2 values.
Results: For all data points (n = 78) for all patients combined, rSO2 values were significantly correlated with SjvO2 values (r = 0.513, P ＜ 0.0001). There were significant correlations between arterial carbon dioxide and values of SjvO2 (r = 0.393, P = 0.0002) and rSO2 (r = 0.432, P ＜ 0.0001).
Conclusions: We concluded that NIRS correlates with SjvO2 in this patient population. These findings suggest that near-infrared spectroscopy may be useful in assessing cerebral oxygenation during OPCAB surgery.

영어초록

Hypoperfusion during manipulation of the heart in off-pump coronary artery bypass (OPCAB) surgery may lead to postoperative neurological complications. Therefore, it will be necessary to monitor cerebral function during OPCAB surgery. In this study, we compared regional cerebral oxygenation (rSO2) by near-infrared spectroscopy (NIRS) with jugular bulb venous oxygen saturation (SjvO2) and assessed whether rSO2 measured by NIRS could be an alternative method of SjvO2 during OPCAB surgery.
Methods: A total of 20 patients who underwent OPCAB surgery were studied. A fiberoptic catheter was placed in the right jugular bulb to measure SjvO2 while a cerebral oximeter based on NIRS, INVOS 5100B was used to monitor rSO2. Radial arterial and jugular bulb blood samples were drawn simultaneously from baseline every hour during operation. The values of rSO2 were compared with SjvO2 values.
Results: For all data points (n = 78) for all patients combined, rSO2 values were significantly correlated with SjvO2 values (r = 0.513, P ＜ 0.0001). There were significant correlations between arterial carbon dioxide and values of SjvO2 (r = 0.393, P = 0.0002) and rSO2 (r = 0.432, P ＜ 0.0001).
Conclusions: We concluded that NIRS correlates with SjvO2 in this patient population. These findings suggest that near-infrared spectroscopy may be useful in assessing cerebral oxygenation during OPCAB surgery.

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