Journal of neurosurgical anesthesiology
-
J Neurosurg Anesthesiol · Oct 2016
Microdialysis as a Part of Invasive Cerebral Monitoring During Porcine Septic Shock.
Metabolic changes in critically ill patients with endotoxin-induced septic shock are measured primarily by techniques that afford organ-specific metabolic monitoring based on interstitial fluid samples. The present study was designed to evaluate the role of cerebral microdialysis (MD) as a part of invasive neuromonitoring during endotoxemia in a porcine model. ⋯ Although our results confirm the special protection of the brain during endotoxemia compared with other organs, early metabolic changes become evident by increasing lactate/pyruvate ratio and lactate/glucose ratio. MD appears to be a suitable additional technique in invasive neuromonitoring for obtaining early information about metabolic deterioration in the brain during septic shock.
-
J Neurosurg Anesthesiol · Oct 2016
Comment Case ReportsBrainstem Contusion: A Fallacy of GCS-BIS Synchrony.
-
J Neurosurg Anesthesiol · Oct 2016
The Effect of Clevidipine on Cerebral Blood Flow Velocity and Carbon Dioxide Reactivity in Human Volunteers.
Clevidipine is a short acting, esterase metabolized, calcium channel antagonist administered as a continuous infusion for control of hypertension. Its profile allows for rapid titration and may be uniquely suited to achieving tight hemodynamic targets in neurosurgical and neurocritical care patients. The present study was designed to investigate the effect of clevidipine infusion on cerebral blood flow and cerebral CO2 responsiveness as measured by cerebral blood flow velocity (CBFV) using transcranial Doppler. ⋯ Clevidipine infusion did not significantly increase CBFV nor was cerebral CO2 reactivity reduced during maximal-dose clevidipine infusion. Further systematic investigation of clevidipine in patients with central nervous system pathology seems justified.
-
J Neurosurg Anesthesiol · Oct 2016
Cerebral Blood Flow Measurement by Near-Infrared Spectroscopy During Carotid Endarterectomy.
It is crucial to evaluate cerebral blood flow (CBF) during carotid endarterectomy (CEA). However, it is difficult to measure CBF in the operating room. The recent development of high-accuracy near-infrared spectroscopy (NIRS) has enabled the measurement of regional CBF following injection of indocyanine green (ICG). We aimed to measure changes in regional CBF by clamping the carotid artery during CEA and to analyze factors affecting the blood flow index (BFI) in CEA. ⋯ The BFI was significantly reduced by carotid artery clamping during CEA. Abnormalities of the circle of Willis were a significant factor contributing to reduced BFI.