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Cerebral hemodynamics during cardiopulmonary bypass in children using near-infrared spectroscopy

Cerebral hemodynamics during cardiopulmonary bypass in children using near-infrared spectroscopy
Cerebral hemodynamics during cardiopulmonary bypass in children using near-infrared spectroscopy

We describe a new noninvasive method using near-infrared spectroscopy for monitoring cerebral hemodynamics during cardiopulmonary bypass in children. All patients were undergoing open heart operations for repair of congenital heart defects. Standardized anesthesia, an alpha-stat method of blood gas management and nonpulsatile flow were used in all cases. All measurements during bypass were made after steady-state conditions had been reached. Cerebral blood flow was measured on 13 occasions in 4 children, aged between 4 and 10 months (median, 5 months). Values of 15.9 to 53.5 mL · 100 g-1 · min-1 were obtained. Cerebral blood volume was measured in 1 patient, aged 4 months. Volumes of 4.3 to 8.0 mL · 100 g-1 were obtained on bypass at full pump flow (2.4 L · min-1 · m-1). On bypass at half flow, the volume increased to 14.7 mL · 100 g-1. Change in cerebral blood volume with changing carbon dioxide tension (CBVR) was measured in 13 patients aged from 1 to 90 months (median, 13.5 months). Preoperatively, CBVR was 0.12 ± 0.07 mL · 100 g-1 · kPa-1 and was independent of mean arterial preasure, which remained between 40 and 80 mm Hg in all cases. During hypothermic bypass (25 °C), CBVR was significantly reduced to 0.05 ± 0.02 mL · 100 g-1 · kPa-1. In addition, there were three values at mean arterial pressure of lower than 40 mm Hg in which CBVR was negative (-0.04 ± 0.01 mL · 100 g-1 · kPa-1). We conclude that near-infrared spectroscopy is useful for the noninvasive investigation of cerebral hemodynamics during cardiopulmonary bypass.

0003-4975
1473-1477
Fallon, Penny
448d79fe-cdb4-427f-aa50-492760899806
Roberts, Idris
8b21d5a7-6eae-4d0d-909b-87e1c63ac9e5
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Elliott, Martin J.
0759cdab-6890-46f6-a24d-55069d8c17b3
Lloyd-Thomas, Adrian
d23f074e-01be-4ffe-b479-9b0eed40cd8b
Maynard, Richard
03229adf-9d1c-47d8-9a2e-47f0390309ef
Edwards, A. David
2df0b540-425b-41cc-b6c1-07e8096c9d04
Fallon, Penny
448d79fe-cdb4-427f-aa50-492760899806
Roberts, Idris
8b21d5a7-6eae-4d0d-909b-87e1c63ac9e5
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Elliott, Martin J.
0759cdab-6890-46f6-a24d-55069d8c17b3
Lloyd-Thomas, Adrian
d23f074e-01be-4ffe-b479-9b0eed40cd8b
Maynard, Richard
03229adf-9d1c-47d8-9a2e-47f0390309ef
Edwards, A. David
2df0b540-425b-41cc-b6c1-07e8096c9d04

Fallon, Penny, Roberts, Idris, Kirkham, Fenella J., Elliott, Martin J., Lloyd-Thomas, Adrian, Maynard, Richard and Edwards, A. David (1993) Cerebral hemodynamics during cardiopulmonary bypass in children using near-infrared spectroscopy. The Annals of Thoracic Surgery, 56 (6), 1473-1477. (doi:10.1016/0003-4975(93)90733-X).

Record type: Article

Abstract

We describe a new noninvasive method using near-infrared spectroscopy for monitoring cerebral hemodynamics during cardiopulmonary bypass in children. All patients were undergoing open heart operations for repair of congenital heart defects. Standardized anesthesia, an alpha-stat method of blood gas management and nonpulsatile flow were used in all cases. All measurements during bypass were made after steady-state conditions had been reached. Cerebral blood flow was measured on 13 occasions in 4 children, aged between 4 and 10 months (median, 5 months). Values of 15.9 to 53.5 mL · 100 g-1 · min-1 were obtained. Cerebral blood volume was measured in 1 patient, aged 4 months. Volumes of 4.3 to 8.0 mL · 100 g-1 were obtained on bypass at full pump flow (2.4 L · min-1 · m-1). On bypass at half flow, the volume increased to 14.7 mL · 100 g-1. Change in cerebral blood volume with changing carbon dioxide tension (CBVR) was measured in 13 patients aged from 1 to 90 months (median, 13.5 months). Preoperatively, CBVR was 0.12 ± 0.07 mL · 100 g-1 · kPa-1 and was independent of mean arterial preasure, which remained between 40 and 80 mm Hg in all cases. During hypothermic bypass (25 °C), CBVR was significantly reduced to 0.05 ± 0.02 mL · 100 g-1 · kPa-1. In addition, there were three values at mean arterial pressure of lower than 40 mm Hg in which CBVR was negative (-0.04 ± 0.01 mL · 100 g-1 · kPa-1). We conclude that near-infrared spectroscopy is useful for the noninvasive investigation of cerebral hemodynamics during cardiopulmonary bypass.

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Published date: December 1993

Identifiers

Local EPrints ID: 429779
URI: https://eprints.soton.ac.uk/id/eprint/429779
ISSN: 0003-4975
PURE UUID: 6477af06-a980-4db1-a794-a9acba1e2153

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Date deposited: 05 Apr 2019 16:30
Last modified: 05 Apr 2019 16:30

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Contributors

Author: Penny Fallon
Author: Idris Roberts
Author: Fenella J. Kirkham
Author: Martin J. Elliott
Author: Adrian Lloyd-Thomas
Author: Richard Maynard
Author: A. David Edwards

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