Monitoring of skeletal muscle oxygenation using near-infrared spectroscopy during abdominal aortic surgery

被引:6
作者
Nakayama M. [1 ]
Iwasaki S. [1 ]
Ichinose H. [2 ]
Yamamoto S. [2 ]
Kanaya N. [1 ]
Namiki A. [1 ]
机构
[1] Department of Anesthesiology, Sapporo Medical University, School of Medicine, Chuo-ku, Sapporo 060-8543, South-1
[2] Division of Anesthesia, Obihiro Kosei Hospital, Obihiro 080-0016, West-6
关键词
Aortic surgery; Monitoring; Near-infrared spectroscopy; Oxygen saturation; Skeletal muscle;
D O I
10.1007/s005400200007
中图分类号
学科分类号
摘要
Purpose. To examine the utility of near-infrared spectroscopy (NIRS) in assessing lower-leg perfusion, NIRS was performed on the calf muscles of patients who underwent abdominal aortic surgery. Methods. Thirty patients undergoing elective infrarenal abdominal aortic surgery for abdominal aortic aneurysm (AAA group; n = 16) and aorto-occlusive disease (AOD group; n = 14) were studied. Before induction of anesthesia, NIRS probes were placed over both calf muscles, and muscle oxygen saturation (StO2) was continuously monitored throughout the surgery. Results. The preoperative StO2 value was significantly lower in the AOD group (57.0 ± 11.2%) than in the AAA group (68.7 ± 7.0%). In both groups, StO2 significantly decreased after aortic cross-clamping; the maximal ischemic value of StO2 in the AAA group (17.8 ± 7.2%) was significantly lower than that in the AOD group (46.7 ± 17.1%). The time taken to reach maximal ischemia was significantly longer in the AAA group (30 ± 12 min) than in the AOD group (19 ± 12 min). After release of the aortic clamp, the decreased StO2 returned to the preoperative level in the AAA group, whereas it increased above the preoperative value in the AOD group. Conclusion. NIRS performed on the calf muscles is a useful method for assessing the changes in lower-leg perfusion during and after abdominal aortic surgery.
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页码:127 / 130
页数:3
相关论文
共 13 条
[1]  
Hampson N.B., Piantadosi C.A., Near infrared monitoring of human skeletal muscle oxygenation during forearm ischemia, J. Appl. Physiol, 64, pp. 2449-2457, (1988)
[2]  
Wilson J.R., Mancini D.M., McCully K., Ferraro N., Lanoce V., Chance B., Noninvasive detection of skeletal muscle underperfusion with near-infrared spectroscopy in patients with heart failure, Circulation, 80, pp. 1668-1674, (1989)
[3]  
Cheatle T.R., Potter L.A., Cope M., Delpy D.T., Smith P.D.C., Scurr J.H., Near-infrared spectroscopy in peripheral vascular disease, Br. J. Surg, 78, pp. 405-408, (1991)
[4]  
McCully K.K., Halber C., Posner J.D., Exercise-induced changes in oxygen saturation in the calf muscles of elderly subjects with peripheral vascular disease, J. Gerontol, 49, (1994)
[5]  
Nakayama M., Iwasaki S., Ichinose H., Yamamoto S., Namiki A., Intraoperative acute lower-extremity ischemia detected by near infrared spectroscopy, Cardiothorac. Vasc. Surg, 15, pp. 624-625, (2001)
[6]  
Eiberg J.P., Schroeder T.V., Vogt K.C., Secher N.H., Near-infrared spectroscopy during peripheral vascular surgery, Cardiovasc. Surg, 5, pp. 304-308, (1997)
[7]  
Svendsen L.B., Flink P., Wojdemann M., Riber C., Mogensen T., Secher N.H., Muscle oxygen saturation during surgery in the lithotomy position, Clin. Physiol, 17, pp. 433-438, (1997)
[8]  
Arbabi S., Brundage S.I., Gentilello L.M., Near-infrared spectroscopy: A potential method for continuous, transcutaneous monitoring for compartment syndrome in critically injured patients, J. Trauma, 47, pp. 829-833, (1999)
[9]  
Giannotti G., Cohn S.M., Brown M., Varela J.E., McKenney M.G., Wisberg J.A., Utility of near-infrared spectroscopy in the diagnosis of lower extremity compartment syndrome, J. Trauma, 48, pp. 396-399, (2000)
[10]  
Johnston W., Balestrieri F.J., Plonk G., D'Souza V., Howard G., The influence of periaortic collateral vessels on the intraoperative hemodynamic effects of acute aortic occlusion in patients with aorto-occlusive disease or abdominal aortic aneurysm, Anesthesiology, 66, pp. 386-389, (1987)