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Esophageal saturation during antegrade cerebral perfusion: a preliminary report using visible light spectroscopy
Author(s) -
HENINGER CARLY,
RAMAMOORTHY CHANDRA,
AMIR GABRIEL,
KAMRA KOMAL,
REDDY V. MOHAN,
HANLEY FRANK L.,
BROCKUTNE JOHN G.
Publication year - 2006
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2006.01965.x
Subject(s) - medicine , cerebral perfusion pressure , cardiopulmonary bypass , anesthesia , perfusion , esophagus , oxygenation , ischemia , cardiac surgery , cerebral hypoperfusion , cardiology , surgery
Summary Background: Visible light spectroscopy (VLS) is newer technology that measures real‐time tissue oxygenation. It has been validated in detecting mucosal ischemia in adults. During complex neonatal heart surgery, antegrade cerebral perfusion (ACP) maintains cerebral saturation. Whether ACP maintains peripheral tissue perfusion in humans is not known. Methods: Five patients undergoing neonatal open heart surgery with hypothermic cardiopulmonary bypass (CPB) were studied using a VLS esophageal probe in addition to bilateral near infrared cerebral oximetry. Three of five patients required ACP for arch repair, while two patients did not. VLS and cerebral saturation data were collected and analyzed in 5 min intervals prior to CPB, during CPB, and during ACP. Results: In the two patients undergoing heart surgery with routine hypothermic CPB, both cerebral and esophageal saturations were maintained. However in all three neonates requiring ACP, although cerebral saturations did not decrease, esophageal saturation fell below the ischemic threshold (35%). Following establishment of normal CPB, esophageal saturation returned to baseline. Conclusions: Antegrade cerebral perfusion maintains cerebral oxygen delivery, however, it does not adequately perfuse the esophagus in neonates. This could have clinical implications.