Ohnishi Y, Horinokuchi N, Hayashi Y, Kuro M, Inamori S
Department of Anesthesiology, National Cardiovascular Center, Suita.
Masui. 1996 Feb;45(2):153-9.
We compared the effects of normothermic (NCPB, N = 5) and moderate hypothermic (HCPB, (N = 5) cardiopulmonary bypass on cerebral oxygen metabolism in patients undergoing coronary artery bypass grafting. For monitoring of cerebral oxygenation, we used jugular venous oxyhemoglobin saturation (SjVO2) and near infrared spectroscopy (NIR). In NCPB group, although SjVO2 decreased temporally at the start of cardiopulmonary bypass, it became stabilized above 50% during the rest of cardiopulmonary bypass. In HCPB group, on the contrary, oxyhemoglobin measured by NIR showed maximum decrease during rewarming under cardiopulmonary bypass. Furthermore, SjVO2 decreased under 50% at the end of cardiopulmonary bypass (3/5 cases). We consider that NCPB is a useful technique for preventing cerebral hypoxia, if the decrease of SjVO2 during the early period of cardiopulmonary bypass is avoidable. Lastly, we also advocate that both SjVO2 and NIR are useful monitoring systems for continuous evaluation of cerebral oxygen metabolism during cardiopulmonary bypass.
我们比较了常温(NCPB,n = 5)和中度低温(HCPB,n = 5)体外循环对冠状动脉搭桥手术患者脑氧代谢的影响。为监测脑氧合,我们使用了颈静脉氧合血红蛋白饱和度(SjVO2)和近红外光谱(NIR)。在NCPB组中,尽管在体外循环开始时SjVO2暂时下降,但在体外循环其余时间内稳定在50%以上。相反,在HCPB组中,NIR测量的氧合血红蛋白在体外循环复温期间显示出最大程度的下降。此外,在体外循环结束时SjVO2降至50%以下(5例中的3例)。我们认为,如果能避免体外循环早期SjVO2的下降,NCPB是预防脑缺氧的一种有用技术。最后,我们还主张SjVO2和NIR都是在体外循环期间连续评估脑氧代谢的有用监测系统。