Investigation of the Relationship between Cerebral Near-Infrared Spectroscopy Measurements and Cerebrovascular Event in Coronary Artery Bypass Grafting Operation in Patients without Carotid Stenosis and Patients with Carotid Stenosis below Surgical Margins.

OBJECTIVES: Stroke is an important cause of mortality and morbidity in surgery. In the present study, we examined the cerebral oximetry values of patients with carotid artery stenosis who did not present surgical indications and those who did not present carotid artery stenosis in coronary artery bypass grafting (CABG) surgery by comparing their cerebral oximetry values with cerebrovascular disease (CVD). METHODS: Between January and May 2014, 40 patients who underwent isolated CABG were included in the study. Cerebral oximetry probes were placed prior to induction of anesthesia. Cerebral oximetry values were recorded before induction, in the pump (cardiopulmonary bypass) inlet period, in the post-clamp period, in the pump outlet period, and in the intensive care unit and neurological complications. RESULTS: There was no difference between the groups in terms of demographic data and routine follow-up parameters. Intraoperative surgical data and early postoperative results were similar in both groups. When comparing the groups, there were no statistically significant results in cerebral oximetry values and CVD development. Only one patient in group 2 had postoperative CVD and this patient was discharged from the hospital with right hemiplegia. Mean arterial pressure (MAP)levels were significantly higher in Group 2 (P<0.05). CONCLUSION: The follow-up of cerebral perfusion with a method like near-infrared spectroscopy (NIRS) will ensure that MAP is adjusted with interventions that will be made according to changes in NIRS. Thus, it will be possible to avoid unnecessary medication and flow-rate increase with cerebral oxygen saturation (rSO2) follow-up.

Investigation of the relationship between cerebral near-infrared spectroscopy measurements and cerebrovascular event in coronary artery bypass grafting operation in patients without carotid stenosis and patients with carotid stenosis below surgical margins

Abstract Objectives: Stroke is an important cause of mortality and morbidity in surgery. In the present study, we examined the cerebral oximetry values of patients with carotid artery stenosis who did not present surgical indications and those who did not present carotid artery stenosis in coronary artery bypass grafting (CABG) surgery by comparing their cerebral oximetry values with cerebrovascular disease (CVD). Methods: Between January and May 2014, 40 patients who underwent isolated CABG were included in the study. Cerebral oximetry probes were placed prior to induction of anesthesia. Cerebral oximetry values were recorded before induction, in the pump (cardiopulmonary bypass) inlet period, in the post-clamp period, in the pump outlet period, and in the intensive care unit and neurological complications. Results: There was no difference between the groups in terms of demographic data and routine follow-up parameters. Intraoperative surgical data and early postoperative results were similar in both groups. When comparing the groups, there were no statistically significant results in cerebral oximetry values and CVD development. Only one patient in group 2 had postoperative CVD and this patient was discharged from the hospital with right hemiplegia. Mean arterial pressure (MAP)levels were significantly higher in Group 2 (P<0.05). Conclusion: The follow-up of cerebral perfusion with a method like near-infrared spectroscopy (NIRS) will ensure that MAP is adjusted with interventions that will be made according to changes in NIRS. Thus, it will be possible to avoid unnecessary medication and flow-rate increase with cerebral oxygen saturation (rSO2) follow-up.

Investigation of the Effect of Pulsatile and Nonpulsatile Flow on Kidney in Coronary Surgery With NIRS.

BACKGROUND: Acute renal insufficiency is a significant cause of morbidity and mortality after coronary artery bypass grafting performed with cardiopulmonary bypass. Functional near-infrared spectroscopy (fNIRS) is an emerging brain-imaging technique that can be used to detect organ perfusions in adults. This study aims to determine the effects of pulsatile and nonpulsatile flow on renal circulation by using functional near-infrared spectroscopy and biochemical markers. METHODS: Forty patients, who had undergone isolated CABG between March 2014 and July 2014 in the authors' clinic, were included in the study. Patients were divided in the pulsatile and nonpulsatile groups by simple randomization. RESULTS: Urine outputs statistically were higher in the pulsatile group, during CPB (P = .045). Renal perfusion measurements via fNIRS intra-operatively statistically were parallel between the groups. When we compared biochemical markers within the groups, in the nonpulsatile group, creatinin statistically is higher on the postoperative first day (P = .003), and BUN statistically is higher on the postoperative first (P = .015), second (P = .001), and fifth (P = .020) days, according to preoperative value. In the pulsatile group, only the postoperative second day BUN is higher (P = .007). CONCLUSION: fNIRS is being used to track cerebral functions. During operation, it also provides a correct observation for blood feeding of somatic organs, such as the kidneys, but it requires more clinical study to be accepted as routine.