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在主动脉弓手术中采用顺行性选择性脑灌注时,使用激光散斑血流图测量眼血流。

Ocular Blood Flow Measured Using Laser Speckle Flowgraphy During Aortic Arch Surgery With Antegrade Selective Cerebral Perfusion.

作者信息

Hayashi Hironobu, Okamoto Masahiro, Kawanishi Hideaki, Matsuura Toyoaki, Tabayashi Nobuoki, Taniguchi Shigeki, Kawaguchi Masahiko

机构信息

Departments of Anesthesiology.

Ophthalmology.

出版信息

J Cardiothorac Vasc Anesth. 2016 Jun;30(3):613-8. doi: 10.1053/j.jvca.2016.01.021. Epub 2016 Jan 18.

Abstract

OBJECTIVE

The objective of this study was to evaluate the validity of ocular blood flow measured using laser speckle flowgraphy (LSFG) for the assessment of cerebral perfusion during aortic arch surgery.

DESIGN

A prospective study.

SETTING

A single university hospital.

PARTICIPANTS

The study included 17 patients undergoing aortic arch surgery with cardiopulmonary bypass (CPB) using antegrade selective cerebral perfusion (ASCP).

INTERVENTIONS

Measurement of ocular blood flow using LSFG.

MEASUREMENTS AND MAIN RESULTS

Measurement of ocular perfusion that is supplied mainly from the ophthalmic artery might be useful as an indicator of cerebral blood flow because the ophthalmic artery is the first branch of the internal carotid artery. Recently, LSFG has been developed for noncontact estimation of ocular perfusion using the laser speckle phenomenon. In this study, the LSFG system was used to measure blood flow in the optic nerve head during aortic arch surgery with CPB using ASCP. The blood flow in the optic nerve head during ASCP was statistically significantly reduced by 40.6% compared with the baseline value after anesthetic induction.

CONCLUSIONS

Ocular blood flow measured using LSFG showed favorable validity for assessment of cerebral perfusion during aortic arch surgery with ASCP.

摘要

目的

本研究的目的是评估使用激光散斑血流图(LSFG)测量眼血流用于评估主动脉弓手术期间脑灌注的有效性。

设计

一项前瞻性研究。

地点

一家大学医院。

参与者

该研究纳入了17例接受主动脉弓手术并行体外循环(CPB)及顺行性选择性脑灌注(ASCP)的患者。

干预措施

使用LSFG测量眼血流。

测量指标及主要结果

由于眼动脉是颈内动脉的第一分支,测量主要由眼动脉供应的眼灌注可能作为脑血流的一个指标。最近,已开发出利用激光散斑现象进行眼灌注非接触估计的LSFG。在本研究中,LSFG系统用于在采用ASCP的CPB主动脉弓手术期间测量视乳头血流。与麻醉诱导后的基线值相比,ASCP期间视乳头血流在统计学上显著降低了40.6%。

结论

使用LSFG测量的眼血流在评估采用ASCP的主动脉弓手术期间的脑灌注方面显示出良好的有效性。

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