Inoue Hisashi, Kase Sachiko, Sato Eiru, Ichiki Akemi, Kuno Yuichiro, Arai Takero, Sato Yoji, Okuda Yasuhisa
Department of Anesthesiology, Koshigaya Hospital Dokkyo University School of Medicine, Koshigaya.
Masui. 2006 Sep;55(9):1164-7.
We monitored sublingual tissue PCO2 (PSLCO2) continuously with an ISFET (ion-sensitive field effect transistor) based PCO2 sensor during and after surgical treatment for descending aortic aneurysm. Using femoro-femoral bypass and a beating heart technique, distal end of aneurysm was clamped and then selective cerebral perfusion was performed into the left subclavian and left common carotid arteries. Aneurysmectomy and reconstructive surgery were carried out with proximal end of the left common carotid artery being clamped. Upon starting selective cerebral perfusion, PSLCO2 increased abnormally. PSLCO2 increased from 38 mmHg just after induction of anesthesia to the maximum value of 87 mmHg during selective cerebral perfusion. Three hours after arriving in the intensive care unit, the patient developed convulsion and anisocoria and the computed tomography showed cerebral infraction. Since the blood flow to the tongue is fed through the internal and external carotid arteries, the increase in PSLCO2 is supposed to be caused by the decrease of blood flow to the tongue during selective cerebral perfusion. The monitoring of PSLCO2 may be a useful method to estimate the brain blood flow during selective cerebral perfusion.
在降主动脉瘤手术治疗期间及术后，我们使用基于离子敏感场效应晶体管（ISFET）的PCO2传感器持续监测舌下组织PCO2（PSLCO2）。采用股-股旁路和心脏跳动技术，夹闭动脉瘤远端，然后向左锁骨下动脉和左颈总动脉进行选择性脑灌注。夹闭左颈总动脉近端后进行动脉瘤切除术和重建手术。开始选择性脑灌注后，PSLCO2异常升高。PSLCO2从麻醉诱导后刚测的38 mmHg升高至选择性脑灌注期间的最大值87 mmHg。进入重症监护病房三小时后，患者出现惊厥和瞳孔不等大，计算机断层扫描显示脑梗死。由于舌部的血流通过颈内动脉和颈外动脉供应，PSLCO2升高推测是由选择性脑灌注期间舌部血流减少所致。监测PSLCO2可能是评估选择性脑灌注期间脑血流量的一种有用方法。
