Spatially extended versus frontal cerebral near-infrared spectroscopy during cardiac surgery: a case series identifying potential advantages.

Rummel, Christian; Basciani, Reto Marco; Nirkko, Arto Christian; Schroth, Gerhard; Stucki, Monika Pia; Reineke, David Christian; Eberle, Balthasar; Kaiser, Heiko (2018). Spatially extended versus frontal cerebral near-infrared spectroscopy during cardiac surgery: a case series identifying potential advantages. Journal of biomedical optics, 23(1), pp. 1-11. SPIE International Society for Optical Engineering 10.1117/1.JBO.23.1.016012

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Stroke due to hypoperfusion or emboli is a devastating adverse event of cardiac surgery, but early detection and treatment could protect patients from an unfavorable postoperative course. Hypoperfusion and emboli can be detected with transcranial Doppler of the middle cerebral artery (MCA). The measured blood flow velocity correlates with cerebral oxygenation determined clinically by near-infrared spectroscopy (NIRS) of the frontal cortex. We tested the potential advantage of a spatially extended NIRS in detecting critical events in three cardiac surgery patients with a whole-head fiber holder of the FOIRE-3000 continuous-wave NIRS system. Principle components analysis was performed to differentiate between global and localized hypoperfusion or ischemic territories of the middle and anterior cerebral arteries. In one patient, we detected a critical hypoperfusion of the right MCA, which was not apparent in the frontal channels but was accompanied by intra- and postoperative neurological correlates of ischemia. We conclude that spatially extended NIRS of temporal and parietal vascular territories could improve the detection of critically low cerebral perfusion. Even in severe hemispheric stroke, NIRS of the frontal lobe may remain normal because the anterior cerebral artery can be supplied by the contralateral side directly or via the anterior communicating artery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Rummel, Christian; Basciani, Reto Marco; Nirkko, Arto Christian; Schroth, Gerhard; Stucki, Monika Pia; Reineke, David Christian; Eberle, Balthasar and Kaiser, Heiko

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1083-3668

Publisher:

SPIE International Society for Optical Engineering

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

02 Feb 2018 14:15

Last Modified:

02 Feb 2018 14:15

Publisher DOI:

10.1117/1.JBO.23.1.016012

PubMed ID:

29359545

Uncontrolled Keywords:

cardiovascular surgical procedures infarction middle cerebral artery near-infrared neuroimaging patient outcome assessment spectroscopy

URI:

https://boris.unibe.ch/id/eprint/110714

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