[利用颈静脉血氧饱和度评估常温体外循环期间的脑氧平衡]

[Evaluation of cerebral oxygen balance during normothermic cardiopulmonary bypass using jugular oxygen saturation].

作者信息

Uesugi Fumihiko, Nakagawa Itsuo, Hidaka Shozo, Kubo Takashi, Okamura Kenta, Kato Takahiro

机构信息

Department of Anesthesia, Chugoku Rosai General Hospital, Kure.

出版信息

Masui. 2005 Jul;54(7):742-6.

PMID:16026053

Abstract

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 (SjO2).

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 SjO2 monitoring. We measured mean arterial pressure (MAP), SjO2 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 x dl(-1)) and 30 min (7.1 +/- 1.0 g x dl(-1)) and 60 min (7.1 +/- 0.8 g x dl(-1)) after the onset of CPB compared with the pre CPB (11 +/- 1.0 g x dl(-1)) value. However, SjO2 showed no significant change throughout the study period. No significant correlation was observed between MAP and SjO2.

CONCLUSIONS

Cerebral oxygen balance assessed by SjO2 was not impaired during normothermic CPB, and was unaffected by hypotension and hemodilution.

摘要

背景

先前的研究表明，常温体外循环（CPB）会损害脑氧平衡。我们通过连续测量颈静脉血氧饱和度（SjO2）研究了常温CPB对脑氧平衡的影响。

方法

对11例行常温CPB冠状动脉搭桥术的患者进行研究。将一根4F血氧测定导管插入颈内静脉球部以监测SjO2。我们在五个时间点测量平均动脉压（MAP）、SjO2和血红蛋白（Hgb）浓度，分别为：1）CPB前；2）3）4）CPB开始后5、30、60分钟；5）CPB结束后5分钟。

结果

与CPB前（80±14mmHg）相比，CPB开始后30分钟（47±9mmHg）和60分钟（48±9mmHg）MAP显著降低。与CPB前（11±1.0g·dl⁻¹）相比，CPB开始后5分钟（7.8±1.1g·dl⁻¹）、30分钟（7.1±1.0g·dl⁻¹）和60分钟（7.1±0.8g·dl⁻¹）Hgb也显著降低。然而，在整个研究期间SjO2无显著变化。MAP与SjO2之间未观察到显著相关性。