PMID- 25002392
OWN - NLM
STAT- MEDLINE
DCOM- 20150413
LR  - 20140708
IS  - 1522-6662 (Electronic)
IS  - 1098-3511 (Linking)
VI  - 17
IP  - 3
DP  - 2014 Jun
TI  - Efficacy of near-infrared spectrometry for monitoring the cerebral effects of 
      severe dilutional anemia.
PG  - E154-9
LID - 10.1532/HSF98.2013293 [doi]
AB  - INTRODUCTION: Clear guidelines for red cell transfusion during cardiac surgery 
      have not yet been established. The current focus on blood conservation during 
      cardiac surgery has increased the urgency to determine the minimum safe 
      hematocrit for these patients. The aim of this study was to determine whether 
      monitoring of cerebral regional oxygen saturation (rSO2) via near-infrared 
      spectrometry (NIRS) is effective for assessing the cerebral effects of severe 
      dilutional anemia during elective coronary arterial bypass graft surgery (CABG). 
      METHODS: The prospective observational study involved patients who underwent 
      cerebral rSO2 monitoring by NIRS during elective isolated first-time CABG: an 
      anemic group (N=15) (minimum Hemoglobin (Hb) <7 g/dL at any period during 
      cardiopulmonary bypass (CPB) and a control group (N=15) (Hb >8 g/dL during CPB). 
      Mean arterial pressure (MAP), pump blood flow, blood lactate level, pCO2, pO2 at 
      five time points and cross-clamp time, extracorporeal circulation time were 
      recorded for each patient. Group results statistically were compared. RESULTS: 
      The anemic group had significantly lower mean preoperative Hb than the control 
      group (10.3 mg/dL versus 14.2 mg/dL; P = .001). The lowest Hb levels were 
      observed in the hypothermic period of CPB in the anemic group. None of the 
      controls exhibited a >20% decrease in cerebral rSO2. Eleven (73.3%) of the anemic 
      patients required an increase in pump blood flow to raise their cerebral rSO2. 
      CONCLUSIONS: In this study, the changes in cerebral rSO2 in the patients with low 
      Hb were within acceptable limits, and this was in concordance with the blood 
      lactate levels and blood-gas analysis. It can be suggested that NIRS monitoring 
      of cerebral rSO2 can assist in decision making related to blood transfusion and 
      dilutional anemia during CPB.
FAU - Cem, Ariturk
AU  - Cem A
AD  - Department of Cardiovascular Surgery, Acibadem University School of Medicine, 
      Atasehir, Istanbul, Turkey.
FAU - Serpil, Ustalar Ozgen Zehra
AU  - Serpil UO
AD  - Department of Anesthesiology and Reanimation, Acibadem University School of 
      Medicine, Atasehir, Istanbul, Turkey.
FAU - Fevzi, Toraman
AU  - Fevzi T
AD  - Department of Anesthesiology and Reanimation, Acibadem University School of 
      Medicine, Atasehir, Istanbul, Turkey.
FAU - Murat, Okten
AU  - Murat O
AD  - Department of Cardiovascular Surgery, Acibadem University School of Medicine, 
      Atasehir, Istanbul, Turkey.
FAU - Umit, Gullu
AU  - Umit G
AD  - Department of Cardiovascular Surgery, Acibadem University School of Medicine, 
      Atasehir, Istanbul, Turkey.
FAU - Esin, Erkek
AU  - Esin E
AD  - Department of Cardiovascular Surgery, Acibadem Healthcare Group, Acibadem Kadikoy 
      Hospital, Kadikoy, Istanbul, Turkey.
FAU - Pinar, Uysal
AU  - Pinar U
AD  - Department of Cardiovascular Surgery, Acibadem Healthcare Group, Acibadem Kadikoy 
      Hospital, Kadikoy, Istanbul, Turkey.
FAU - Sahin, Sensy
AU  - Sahin S
AD  - Department of Cardiovascular Surgery, Acibadem University School of Medicine, 
      Atasehir, Istanbul, Turkey.
FAU - Hasan, Karabulut
AU  - Hasan K
AD  - Department of Cardiovascular Surgery, Acibadem University School of Medicine, 
      Atasehir, Istanbul, Turkey.
FAU - Cem, Alhan
AU  - Cem A
AD  - Department of Cardiovascular Surgery, Acibadem University School of Medicine, 
      Atasehir, Istanbul, Turkey.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Heart Surg Forum
JT  - The heart surgery forum
JID - 100891112
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Anemia/diagnosis/etiology/*prevention & control
MH  - Brain/*metabolism
MH  - Coronary Artery Bypass/*adverse effects
MH  - Erythrocyte Transfusion/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/*methods
MH  - Oximetry/methods
MH  - Oxygen/*metabolism
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Spectroscopy, Near-Infrared/*methods
MH  - Treatment Outcome
EDAT- 2014/07/09 06:00
MHDA- 2015/04/14 06:00
CRDT- 2014/07/09 06:00
PHST- 2014/07/09 06:00 [entrez]
PHST- 2014/07/09 06:00 [pubmed]
PHST- 2015/04/14 06:00 [medline]
AID - 62022775T62312H4 [pii]
AID - 10.1532/HSF98.2013293 [doi]
PST - ppublish
SO  - Heart Surg Forum. 2014 Jun;17(3):E154-9. doi: 10.1532/HSF98.2013293.