Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2020
ReviewNear-Infrared Spectroscopy in Pediatric Congenital Heart Disease.
Near-infrared spectroscopy (NIRS) is widely used to monitor tissue oxygenation in the pediatric cardiac surgical population. Clinicians who use NIRS must understand the underlying measurement principles in order to interpret and use this monitoring modality appropriately. The aims of this narrative review are to provide a brief overview of NIRS technology, discuss the normative and critical values of cerebral and somatic tissue oxygen saturation and the interpretation of these values, present the clinical studies (and their limitations) of NIRS as a perioperative monitoring modality in the pediatric congenital heart disease population, and introduce the emerging and future applications of NIRS.
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J. Cardiothorac. Vasc. Anesth. · Feb 2020
Measuring Cerebral Carbon Dioxide Reactivity With Transcranial Doppler and Near-Infrared Spectroscopy in Children With Ventricular Septal Defect.
Neurologic impairment is frequently observed in children with congenital heart disease. Impairment in cerebrovascular carbon dioxide reactivity (CO2R) is related with poor neurologic outcomes. The present study examined CO2R measured with transcranial Doppler (TCD) and near-infrared spectroscopy (NIRS) in children with ventricular septal defect undergoing cardiac surgery. ⋯ During anesthesia, CO2R remains preserved in children with a ventricular septal defect. Even though there is lack of correlation between CO2R-TCD and CO2R-NIRS, changes in TOI and VMCA were correlated as the PETCO2 changed. NIRS may be used as a surrogate to investigate CO2R when the ultrasound window is poor.
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J. Cardiothorac. Vasc. Anesth. · Feb 2020
Oxygen Reserve Index Predicts Hypoxemia During One-Lung Ventilation: An Observational Diagnostic Study.
To determine the accuracy of the Oxygen Reserve Index (ORi) to predict hypoxemia during one-lung ventilation (OLV). ⋯ An ORi value equal to zero, 5 minutes after the onset of mechanical ventilation in the supine position, predicts the development of hypoxemia during OLV. These findings may be helpful to adjust FIO2 individually in patients undergoing OLV and to avoid unnecessary high concentrations of oxygen.