Serebral Oksimetre Ve Anestezi Altında Uygulama Alanları

Serebral oksimetre frontal korteks üzerinde transkütanöz membrandan ortalama bölgesel doku oksijenizasyonunu değerlendirir. Verici dioddan çıkan ışınların alıcı diodlarca algılanması temelinde çalışır. Serebral oksimetre 30 yılı aşkın süre önce tanımlanmıştır. Rutin olarak tüm operasyonlarda uygulanmamakla birlikte ve son iki dekad süresince özellikli klinik uygulamalarda kullanılmaya başlanmıştır. Noninvazif near infrared spektroskopi (NIRS) tekniğiyle çalışan bir monitörizasyondur. Kardiyak cerrahiler, hipotansif cerrahiler ve traendelenburg pozisyonda uzun süre takip edilen hastalarda serebral doku oksijen düzeyini değerlendirmede fayda sağladığı farklı çalışmalarla gösterilmiştir.

Anahtar Kelimeler:

Oksimetre, Kardiyak Cerrahi, Hipotansiyon

Cerebral Oximetry and Applications Under Anesthesia

Cerebral oximetry assesses the average regional tissue oxygenation of the transcutaneous membrane over the frontal cortex. The transmitter operates on the basis of detection of the diodes from the diodes. Cerebral oxymetry has been described more than 30 years ago. It has not been routinely used in clinical operations but applied in special clinical conditions during the last two decades. It is a monitarisation technique which uses noninvasive near-infrared spectroscopy (NIRS). Different studies have shown benefical results with cerebral oxymetry in cardiac surgery, hypotensive surgery and patients with long-term follow-up at trendelenburg position for assessing cerebral tissue oxygen levels.

Keywords:

Oximetry, Cardiac Surgery, Hypotension,

PDF

___

1. Page B. Assessing O(2) Saturation: The how, what and why of pulse oximetry. JEMS : a journal of emergency medical services. 2017;42(5):49-53.
2. Vegh T. Cerebral Oximetry in General Anaesthesia. Turkish journal of anaesthesiology and reanimation. 2016;44(5):247-9.
3. Butterworth JF, Mackey DC. Noncardiovascular monitorisations. Fifth ed. New York: McGraw-Hill; 2015; pp 126-127
4. Erol S, Günaydın B. Jinekolojik Laparoskopik Cerrahide Serebral Oksimetre Kullanımının Önemi. Gazi Med J. 2012;127(23):126-32.
5. Parnia S. Cerebral oximetry leading up to cardiac arrest: A marker of the impact of mean arterial pressure on the brain, but not time of death. Resuscitation. 2017;121:A1.
6. Yetkin U, Karahan N, Gürbüz A. Klinik Uygulamada Pulse Oksimetre. Van Tıp Dergisi. 2002;9(4):126-33.
7. Steppan J, Hogue CW, Jr. Cerebral and tissue oximetry. Best practice & research Clinical anaesthesiology. 2014;28(4):429-39.
8. Asim K, Ozlem B, Gokhan E, Zihni Y, Deniz O, Mahmut T, et al. The Use of Cerebral Oximetry in Acute Carbon Monoxide Intoxication: A Preliminary Study. The Keio journal of medicine. 2015;64(4):57-61.
9. Hong SW, Shim JK, Choi YS, Kim DH, Chang BC, Kwak YL. Prediction of cognitive dysfunction and patients' outcome following valvular heart surgery and the role of cerebral oximetry. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2008;33(4):560-5.
10. Deschamps A, Hall R, Grocott H, Mazer CD, Choi PT, Turgeon AF, et al. Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery: A Randomized Controlled Feasibility Trial. Anesthesiology. 2016;124(4):826-36.
11. Pennekamp CW, Moll FL, de Borst GJ. The potential benefits and the role of cerebral monitoring in carotid endarterectomy. Current opinion in anaesthesiology. 2011;24(6):693-7.
12. Kahraman S, Kayali H, Atabey C, Acar F, Gocmen S. The accuracy of near-infrared spectroscopy in detection of subdural and epidural hematomas. The Journal of trauma. 2006;61(6):1480-3.
13. Gopinath SP, Robertson CS, Contant CF, Narayan RK, Grossman RG, Chance B. Early detection of delayed traumatic intracranial hematomas using near-infrared spectroscopy. Journal of neurosurgery. 1995;83(3):438-44.
14. Mahal I, Davie SN, Grocott HP. Cerebral oximetry and thoracic surgery. Current opinion in anaesthesiology. 2014;27(1):21-7.
15. Kazan R, Bracco D, Hemmerling TM. Reduced cerebral oxygen saturation measured by absolute cerebral oximetry during thoracic surgery correlates with postoperative complications. British journal of anaesthesia. 2009;103(6):811-6.
16. Vegh T, Szatmari S, Juhasz M, Laszlo I, Vasko A, Takacs I, et al. One-lung ventilation does not result in cerebral desaturation during application of lung protective strategy if normocapnia is maintained. Acta physiologica Hungarica. 2013;100(2):163-72.
17. Koh JL, Levin SD, Chehab EL, Murphy GS. Neer Award 2012: cerebral oxygenation in the beach chair position: a prospective study on the effect of general anesthesia compared with regional anesthesia and sedation. Journal of shoulder and elbow surgery. 2013;22(10):1325-31.
18. Ghosh A, Elwell C, Smith M. Review article: cerebral near-infrared spectroscopy in adults: a work in progress. Anesthesia and analgesia. 2012;115(6):1373-83.
19. Wolf M, Ferrari M, Quaresima V. Progress of near-infrared spectroscopy and topography for brain and muscle clinical applications. Journal of biomedical optics. 2007;12(6):062104.
20. Highton D, Elwell C, Smith M. Noninvasive cerebral oximetry: is there light at the end of the tunnel? Current opinion in anaesthesiology. 2010;23(5):576-81.
21. Pedersen T, Nicholson A, Hovhannisyan K, Moller AM, Smith AF, Lewis SR. Pulse oximetry for perioperative monitoring. The Cochrane database of systematic reviews. 2014(3):Cd002013.