Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series.
Ann Card Anaesth
;
2016 Jan; 19(1): 59-62
Artigo
em Inglês
| IMSEAR
| ID: sea-172277
ABSTRACT
Background:
Patients with significant bilateral carotid artery stenosis requiring urgent cardiac surgery have an increased risk of stroke and death. The optimal management strategy remains inconclusive, and the available evidence does not support the superiority of one strategy over another. Materials andMethods:
A number of noninvasive strategies have been developed for minimizing perioperative stroke including continuous real‑time monitoring of cerebral oxygenation with near‑infrared spectroscopy (NIRS). The number of patients presenting with this combination (bilateral significant carotid stenosis requiring urgent cardiac surgery) in any single institution will be small and hence there is a lack of large randomized studies.Results:
This case series describes our early experience with NIRS in a select group of patients with significant bilateral carotid stenosis undergoing urgent cardiac surgery (n = 8). In contrast to other studies, this series is a single surgeon, single center study, where the entire surgery (both distal ends and proximal ends) was performed during single aortic clamp technique, which effectively removes several confounding variables. NIRS monitoring led to the early recognition of decreased cerebral oxygenation, and corrective steps (increased cardiopulmonary bypass flow, increased pCO2, etc.,) were taken.Conclusion:
The study shows good clinical outcome with the use of NIRS. This is our “work in progress,” and we aim to conduct a larger study.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Tipo de estudo:
Ensaio Clínico Controlado
Idioma:
Inglês
Revista:
Ann Card Anaesth
Ano de publicação:
2016
Tipo de documento:
Artigo
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