Evaluation of cerebral oxygen balance during normothermic cardiopulmonary bypass using jugular oxygen saturation
Uesugi, F.; Nakagawa, I.; Hidaka, S.; Kubo, T.; Okamura, K.; Kato, T.
Masui. Japanese Journal of Anesthesiology 54(7): 742-746
2005
ISSN/ISBN: 0021-4892 PMID: 16026053 Document Number: 584715
Background: Previous studies suggest that normothermic cardiopulmonary bypass(CPB) impairs cerebral oxygen balance. We studied the effect of normothermic CPB on cerebral oxygen balance evaluated by continuous measurement of oxygen saturation in the jugular vein (SjO(2)).Methods: Eleven patients undergoing coronary artery bypass grafting with normothermic CPB were studied. A 4 Fr oxymetry catheter was inserted into the internal jugular bulb for SjO(2) monitoring. We measured mean arterial pressure (MAP), SjO(2) and hemoglobin (Hgb) concentration at five time points-1) pre CPB, 2) 3) 4) 5, 30, 60 min after the onset of CPB, respectively, 5) 5 min after the end of CPB.Results: MAP decreased significantly 30 min (47 +/- 9 mmHg) and 60 min (48 +/- 9 mmHg) after the onset of CPB compared with the pre CPB (80 +/- 14 mmHg) value. Hgb also decreased significantly 5 min (7.8 +/- 1.1 g . dl(-1)) and 30 min (7.1 +/- 1.0 g . dl(-1)) and 60 min (7.1 +/- 0.8 g . dl(-1)) after the onset of CPB compared with the pre CPB (11 +/- 1.0 g . dl(-1)) value. However, SjO(2), showed no significant change throughout the study period. No significant correlation was observed between MAP and SjO(2),Conclusions: Cerebral oxygen balance assessed by SjO(2), was not impaired during normothermic CPB, and was unaffected by hypotension and hemodilution.