Cerebral tissue oxygenation and oxidative brain injury during ischemia and reperfusion

10.2741/2150 ◽  
2007 ◽  
Vol 12 (1) ◽  
pp. 1318 ◽  
Author(s):  
Honglian Shi
Keyword(s):  
Brain Injury ◽  
Tissue Oxygenation ◽  
Ischemia And Reperfusion ◽  
Cerebral Tissue ◽  
Cerebral Tissue Oxygenation ◽  
Oxidative Brain Injury

Assessment of a noninvasive cerebral oxygenation monitor in patients with severe traumatic brain injury

2014 ◽  
Vol 120 (4) ◽  
pp. 901-907 ◽  
Author(s):  
Guy Rosenthal ◽  
Alex Furmanov ◽  
Eyal Itshayek ◽  
Yigal Shoshan ◽  
Vineeta Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tissue Oxygenation ◽  
Cerebral Oxygenation ◽  
Jugular Bulb ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Brain Tissue Oxygen ◽  
Severe Tbi ◽  
Cerebral Tissue Oxygenation

Object Development of a noninvasive monitor to assess cerebral oxygenation has long been a goal in neurocritical care. The authors evaluated the feasibility and utility of a noninvasive cerebral oxygenation monitor, the CerOx 3110, which uses near-infrared spectroscopy and ultrasound to measure regional cerebral tissue oxygenation in patients with severe traumatic brain injury (TBI), and compared measurements obtained using this device to those obtained using invasive cerebral monitoring. Methods Patients with severe TBI admitted to the intensive care unit at Hadassah-Hebrew University Hospital requiring intracranial pressure (ICP) monitoring and advanced neuromonitoring were included in this study. The authors assessed 18 patients with severe TBI using the CerOx monitor and invasive advanced cerebral monitors. Results The mean age of the patients was 45.3 ± 23.7 years and the median Glasgow Coma Scale score on admission was 5 (interquartile range 3–7). Eight patients underwent unilateral decompressive hemicraniectomy and 1 patient underwent craniotomy. Sixteen patients underwent insertion of a jugular bulb venous catheter, and 18 patients underwent insertion of a Licox brain tissue oxygen monitor. The authors found a strong correlation (r = 0.60, p < 0.001) between the jugular bulb venous saturation from the venous blood gas and the CerOx measure of regional cerebral tissue saturation on the side ipsilateral to the catheter. A multivariate analysis revealed that among the physiological parameters of mean arterial blood pressure, ICP, brain tissue oxygen tension, and CerOx measurements on the ipsilateral and contralateral sides, only ipsilateral CerOx measurements were significantly correlated to jugular bulb venous saturation (p < 0.001). Conclusions Measuring regional cerebral tissue oxygenation with the CerOx monitor in a noninvasive manner is feasible in patients with severe TBI in the neurointensive care unit. The correlation between the CerOx measurements and the jugular bulb venous measurements of oxygen saturation indicate that the CerOx may be able to provide an estimation of cerebral oxygenation status in a noninvasive manner.

Advanced neuromonitoring including cerebral tissue oxygenation and outcome after traumatic brain injury

2001 ◽  
Vol 23 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Albert Väth ◽  
Jürgen Meixensberger ◽  
Jim Dings ◽  
Klaus Roosen
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tissue Oxygenation ◽  
Cerebral Tissue ◽  
Cerebral Tissue Oxygenation

scholarly journals Epinephrine’s effects on cerebrovascular and systemic hemodynamics during cardiopulmonary resuscitation

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Constantine D. Mavroudis ◽  
Tiffany S. Ko ◽  
Ryan W. Morgan ◽  
Lindsay E. Volk ◽  
William P. Landis ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Animal Studies ◽  
Tissue Oxygenation ◽  
Cerebral Oxygenation ◽  
Acute Effect ◽  
Correlation Spectroscopy ◽  
Neurological Injury ◽  
Swine Model ◽  
Cerebral Tissue ◽  
Cerebral Tissue Oxygenation

Abstract Background Despite controversies, epinephrine remains a mainstay of cardiopulmonary resuscitation (CPR). Recent animal studies have suggested that epinephrine may decrease cerebral blood flow (CBF) and cerebral oxygenation, possibly potentiating neurological injury during CPR. We investigated the cerebrovascular effects of intravenous epinephrine in a swine model of pediatric in-hospital cardiac arrest. The primary objectives of this study were to determine if (1) epinephrine doses have a significant acute effect on CBF and cerebral tissue oxygenation during CPR and (2) if the effect of each subsequent dose of epinephrine differs significantly from that of the first. Methods One-month-old piglets (n = 20) underwent asphyxia for 7 min, ventricular fibrillation, and CPR for 10–20 min. Epinephrine (20 mcg/kg) was administered at 2, 6, 10, 14, and 18 min of CPR. Invasive (laser Doppler, brain tissue oxygen tension [PbtO2]) and noninvasive (diffuse correlation spectroscopy and diffuse optical spectroscopy) measurements of CBF and cerebral tissue oxygenation were simultaneously recorded. Effects of subsequent epinephrine doses were compared to the first. Results With the first epinephrine dose during CPR, CBF and cerebral tissue oxygenation increased by > 10%, as measured by each of the invasive and noninvasive measures (p < 0.001). The effects of epinephrine on CBF and cerebral tissue oxygenation decreased with subsequent doses. By the fifth dose of epinephrine, there were no demonstrable increases in CBF of cerebral tissue oxygenation. Invasive and noninvasive CBF measurements were highly correlated during asphyxia (slope effect 1.3, p < 0.001) and CPR (slope effect 0.20, p < 0.001). Conclusions This model suggests that epinephrine increases CBF and cerebral tissue oxygenation, but that effects wane following the third dose. Noninvasive measurements of neurological health parameters hold promise for developing and directing resuscitation strategies.

scholarly journals Physiologically based cord clamping improves cardiopulmonary haemodynamics in lambs with a diaphragmatic hernia

2019 ◽  
Vol 105 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Aidan J Kashyap ◽  
Ryan J Hodges ◽  
Marta Thio ◽  
Karyn A Rodgers ◽  
Ben J Amberg ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Tissue Oxygenation ◽  
Lung Hypoplasia ◽  
Physiological Changes ◽  
Cerebral Tissue ◽  
Maximum Delay ◽  
Cord Clamping ◽  
Physiologically Based ◽  
Cerebral Tissue Oxygenation ◽  
Surgically Induced

ObjectiveLung hypoplasia associated with congenital diaphragmatic hernia (CDH) results in respiratory insufficiency and pulmonary hypertension after birth. We have investigated whether aerating the lung before removing placental support (physiologically based cord clamping (PBCC)), improves the cardiopulmonary transition in lambs with a CDH.MethodsAt ≈138 days of gestational age, 17 lambs with surgically induced left-sided diaphragmatic hernia (≈d80) were delivered via caesarean section. The umbilical cord was clamped either immediately prior to ventilation onset (immediate cord clamping (ICC); n=6) or after achieving a target tidal volume of 4 mL/kg, with a maximum delay of 10 min (PBCC; n=11). Lambs were ventilated for 120 min and physiological changes recorded.ResultsPulmonary blood flow (PBF) increased following ventilation onset in both groups, but was 19-fold greater in PBCC compared with ICC lambs at cord clamping (19±6.3 vs 1.0±0.5 mL/min/kg, p<0.001). Cerebral tissue oxygenation was higher in PBCC than ICC lambs during the first 10 min after cord clamping (59%±4% vs 30%±5%, p<0.001). PBF was threefold higher (23±4 vs 8±2 mL/min/kg, p=0.01) and pulmonary vascular resistance (PVR) was threefold lower (0.6±0.1 vs 2.2±0.6 mm Hg/(mL/min), p<0.001) in PBCC lambs compared with ICC lambs at 120 min after ventilation onset.ConclusionsCompared with ICC, PBCC prevented the severe asphyxia immediately after birth and resulted in a higher PBF due to a lower PVR, which persisted for at least 120 min after birth in CDH lambs.

scholarly journals PO-0725e Cerebral Tissue Oxygenation At Birth In Term Infants: Comparison Between Early And Late Cord Clamping

2014 ◽  
Vol 99 (Suppl 2) ◽  
pp. A492.2-A493
Author(s):  
B Arcagok ◽  
H Bilgen ◽  
S Coskun ◽  
M Guclu ◽  
D Save ◽  
...  
Keyword(s):  
Tissue Oxygenation ◽  
Cerebral Tissue ◽  
Term Infants ◽  
Cord Clamping ◽  
Cerebral Tissue Oxygenation
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