Cerebral monitoring to optimize outcomes after cardiac surgery

被引:45
作者
Fedorow, Christine [1 ]
Grocott, Hilary P. [1 ]
机构
[1] Univ Manitoba, IH Asper Inst Clin Res, Dept Anesthesia, Winnipeg, MB R2H 2A6, Canada
关键词
brain; cardiac surgery; cardiopulmonary bypass; monitoring; outcome; CORONARY-ARTERY BYPASS; HYPOTHERMIC CARDIOPULMONARY BYPASS; PREDICTS COGNITIVE DECLINE; LONGER HOSPITAL STAY; OXYGEN DESATURATION; BISPECTRAL INDEX; SURGICAL-TREATMENT; RANDOMIZED-TRIAL; PULSE OXIMETRY; BLOOD-FLOW;
D O I
10.1097/ACO.0b013e3283346d10
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose of review Although significant achievements have been made in the perioperative care of patients undergoing cardiac surgery, adverse cerebral outcomes remain an ongoing concern. Multiple approaches have been utilized to address neurologic complications, though definitive therapeutic strategies are lacking. This review focuses on the various cerebral monitoring options that can be used in cardiac surgery to improve perioperative outcomes. Recent findings Prevention of adverse outcomes has shown promise, and central to this is the identification of conditions, through cerebral monitoring, which may put the brain at risk. Multimodal cerebral monitoring utilizing hemodynamics, temperature, electroencephalography, and near-infrared spectroscopy techniques allow for the manipulation of perioperative conditions aimed at improving cerebral outcome. Summary The use of a comprehensive cerebral monitoring strategy can optimize cerebral outcomes after cardiac surgery.
引用
收藏
页码:89 / 94
页数:6
相关论文
共 40 条
[1]   Anesthesia awareness and the bispectral index [J].
Avidan, Michael S. ;
Zhang, Lini ;
Burnside, Beth A. ;
Finkel, Kevin J. ;
Searleman, Adam C. ;
Selvidge, Jacqueline A. ;
Saager, Leif ;
Turner, Michelle S. ;
Rao, Srikar ;
Bottros, Michael ;
Hantler, Charles ;
Jacobsohn, Eric ;
Evers, Alex S. .
NEW ENGLAND JOURNAL OF MEDICINE, 2008, 358 (11) :1097-1108
[2]   CEREBRAL BLOOD-FLOW IN RATS WITH RENAL AND SPONTANEOUS HYPERTENSION - RESETTING OF THE LOWER LIMIT OF AUTO-REGULATION [J].
BARRY, DI ;
STRANDGAARD, S ;
GRAHAM, DI ;
BRAENDSTRUP, O ;
SVENDSEN, UG ;
VORSTRUP, S ;
HEMMINGSEN, R ;
BOLWIG, TG .
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM, 1982, 2 (03) :347-353
[3]  
Baumgartner WA, 2001, ANN SURG, V234, P342
[4]   New paradigms and improved results for the surgical treatment of acute type A dissection [J].
Bavaria, JE ;
Pochettino, A ;
Brinster, DR ;
Gorman, RC ;
McGarvey, ML ;
Gorman, JH ;
Escherich, A ;
Gardner, TJ .
ANNALS OF SURGERY, 2001, 234 (03) :336-342
[5]  
CAMBONI D, 2008, CARDIOVASC THORAC SU, V7, P922
[6]   JUGULAR BULB SATURATION AND COGNITIVE DYSFUNCTION AFTER CARDIOPULMONARY BYPASS [J].
CROUGHWELL, ND ;
NEWMAN, MF ;
BLUMENTHAL, JA ;
WHITE, WD ;
LEWIS, JB ;
FRASCO, PE ;
SMITH, LR ;
THYRUM, EA ;
HURWITZ, BJ ;
LEONE, BJ ;
SCHELL, RM ;
REVES, JG .
ANNALS OF THORACIC SURGERY, 1994, 58 (06) :1702-1708
[7]   A Proposed Algorithm for the Intraoperative Use of Cerebral Near-Infrared Spectroscopy [J].
Denault, Andre ;
Deschamps, Alain ;
Murkin, John M. .
SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2007, 11 (04) :274-281
[8]   The changes in bispectral index during a hypovolemic cardiac arrest [J].
England, MR .
ANESTHESIOLOGY, 1999, 91 (06) :1947-1949
[9]   ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: Executive summary [J].
Fleisher, Lee A. ;
Beckman, Joshua A. ;
Brown, Kenneth A. ;
Calkins, Hugh ;
Chaikof, Elliott ;
Fleischmann, Kirsten E. ;
Freeman, William K. ;
Froehlich, James B. ;
Kasper, Edward K. ;
Kersten, Judy R. ;
Riegel, Barbara ;
Robb, John F. ;
Smith, Sidney C., Jr. ;
Jacobs, Alice K. ;
Adams, Cynthia D. ;
Anderson, Jeffrey L. ;
Antman, Elliott M. ;
Buller, Christopher E. ;
Creager, Mark A. ;
Ettinger, Steven M. ;
Faxon, David P. ;
Fuster, Valentin ;
Halperin, Jonathan L. ;
Hiratzka, Loren F. ;
Hunt, Sharon A. ;
Lytle, Bruce W. ;
Nishimura, Rick ;
Ornato, Joseph P. ;
Page, Richard L. ;
Riegel, Barbara ;
Tarkington, Lynn G. ;
Yancy, Clyde W. ;
Lewin, John C. ;
Arend, Thomas E., Jr. ;
Fobbs, Kristen N. ;
Keller, Sue ;
Barrett, Erin A. ;
Wheeler, M. Cass ;
Robertson, Rose Marie ;
Taubert, Kathryn A. .
CIRCULATION, 2007, 116 (17) :1971-1996
[10]   IMPROVEMENT OF OUTCOMES AFTER CORONARY-ARTERY BYPASS - A RANDOMIZED TRIAL COMPARING INTRAOPERATIVE HIGH VERSUS LOW MEAN ARTERIAL-PRESSURE [J].
GOLD, JP ;
CHARLSON, ME ;
WILLIAMSRUSSO, P ;
SZATROWSKI, TP ;
PETERSON, JC ;
PIRRAGLIA, PA ;
HARTMAN, GS ;
YAO, FSF ;
HOLLENBERG, JP ;
BARBUT, D ;
HAYES, JG ;
THOMAS, SJ ;
PURCELL, MH ;
MATTIS, S ;
GORKIN, L ;
POST, M ;
KRIEGER, KH ;
ISOM, OW .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1995, 110 (05) :1302-1314