Changes in cerebral oxygenation during cold (28 degrees C) and warm (34 degrees C) cardiopulmonary bypass using different blood gas strategies (alpha-stat and pH-stat) in patients undergoing coronary artery bypass graft surgery

Acta Anaesthesiologica Scandinavica
M Shaaban AliE G Butchart

Abstract

Impaired cerebral oxygenation, which is reflected by measuring jugular bulb oxygenation, is thought to play an important role in the development of neurological injury after cardiac operations with cardiopulmonary bypass (CPB). The effects of cardiopulmonary temperature and blood gas strategy on cerebral oxygenation are not fully appreciated. Sixty patients were randomly allocated into four equal groups (cold alpha-stat, cold pH-stat, warm alpha-stat and warm pH-stat) to compare the effect of these perfusion strategies on cerebral oxygenation monitored by jugular bulb oximetry [jugular bulb oxygen saturation (SjO(2)) and arterial-jugular bulb oxygen content difference (AjDO(2))]. Jugular bulb oxygen saturation and AjDO(2) were measured before CPB, after 5, 20, 40 min on CPB, at start and end of rewarming, 5 min before the end of CPB and 10 min after CPB. Two-way analysis of variance was used to model the lowest SjO(2) and highest AjDO(2) during CPB, with CPB temperature and blood gas management as contributing factors. Significant changes in SjO(2) were only related to the type of blood gas management, with no significant difference between warm and cold CPB patients. In addition, during rewarming, desaturation (SjO(2) </= 50%)...Continue Reading

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Citations

Aug 31, 2013·Journal of Clinical Monitoring and Computing·Steven TeerenstraPatrick W Weerwind
May 18, 2010·Journal of Cardiothoracic and Vascular Anesthesia·Marina SvyatetsJean Charchaflieh
Mar 16, 2005·Anaesthesia·M Shaaban AliF Kirkham
Oct 17, 2006·Paediatric Anaesthesia·Nobuo Jimi, Tsunehiko Shin
Sep 9, 2006·Seminars in Cardiothoracic and Vascular Anesthesia·George N Djaiani
Aug 4, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Francois J SmithPieter J Becker
Dec 22, 2017·Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention·Eric D CaineKristen Quinlan
Aug 4, 2006·Journal of Cardiothoracic and Vascular Anesthesia·George M Hoffman

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