YAKIN KIZILÖTESİ SPEKTROSKOPİSİ İLE ÖLÇÜLEN REJYONEL SEREBRAL OKSİJEN SATÜRASYONU: SİSTEMATİK BİR DERLEME
Near-infrared ışığın dokulara penetre olabilmesi, oksihemoglobin ve deoksihemoglobin tarafındanabsorbe edilebilmesi rejyonel serebral oksijen satürasyon ölçümünün temel prensibinioluşturur. Bu yöntemle, serebral dokunun oksijen arz-talep dengesi devamlı ve gerçek zamanlıolarak değerlendirilebilmektedir. Ölçümlerde, beyinde venöz, kapiller ve arteriyel kompartmanlardabulunan kan volümünün sabit bir değer olduğu varsayılır. Bu sebeple serebral oksimetrelerbu kompartmanlara ait oksijenizasyonla ilgili ortalama bir değer sunmaktadırlar.Düşük rejyonel serebral oksijen satürasyon değerleri serebral hipoksi ve/veya iskemi ile ilişkilendirilmiştir.Ancak serebral oksimetrelerin postoperatif nörolojik komplikasyonları azalttığıyönündeki veriler çelişkilidir. Bu yüzden genel anestezi uygulamalarında rutin bir monitörizasyonyöntemi olarak kullanılması önerilmemiştir. Yine de özellikle kardiyak cerrahi ve karotisendarterektomi cerrahisinde kullanımı faydalı olabilir.
Regional Cerebral Oxygen Saturation Measured by Near-infrared Spectroscopy: A Systematic Review
Penetration of near-infrared light into the tissue and its absorption by oxyhemoglobin and deoxyhemoglobin constitute the basic principle of regional cerebral oxygen saturation measurement. With this method, oxygen supply-demand balance of the cerebral tissue can be evaluated continuously and real-timely. Blood volume present in venous, arterial and capillary compartments of the brain is assumed to be a constant volume in the measurements. Therefore, cerebral oximeters provide an average value related to the oxygenation of these compartments. Low regional cerebral oxygen saturation values were associated with cerebral hypoxia and/or ischemia. However, the data showing that cerebral oximeters decrease postoperative neurological complications are conflicting. Therefore, it has not been suggested as a routine monitoring method in general anaesthesia applications. İts use may be helpful especially in cardiac surgery and carotid endarterectomy surgery.
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