Intraoperative monitoring of cerebral microcirculation and oxygenation-a feasibility study using a novel photo-spectrometric laser-doppler flowmetry

Journal of Neurosurgical Anesthesiology

Volumn 22, Issue 1, 2010, Pages 38-45

  Klein, Klaus Ulrich ^a   Schramm, Patrick ^a   Glaser, Martin ^a   Reisch, Robert ^a   Tresch, Achim ^b   Werner, Christian ^a   Engelhard, Kristin ^a  

^a JOHANNES GUTENBERG UNIVERSITY   (Germany)

^b UNIVERSITY OF MUNICH   (Germany)

Author keywords

Intraoperative; Laser doppler flowmetry; Microcirculation; Neuromonitoring; Photo spectrometry

Indexed keywords

CARBON DIOXIDE; HEMOGLOBIN; INTRAVENOUS ANESTHETIC AGENT; OXYGEN; PROPOFOL; ATRACURIUM; REMIFENTANIL;

ADULT; AGED; ARTICLE; BLOOD FLOW VELOCITY; BRAIN; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CRANIOTOMY; DOSE RESPONSE; DRUG EFFECT; FEASIBILITY STUDY; FEMALE; FIBER OPTICS; GERMANY; HUMAN; LASER DOPPLER FLOWMETRY; MALE; METABOLISM; METHODOLOGY; MICROCIRCULATION; MIDDLE AGED; PATIENT MONITORING; PHOTOMETRY; RANDOMIZED CONTROLLED TRIAL; SPECTROSCOPY; VASCULARIZATION; ARTERIOVENOUS MALFORMATION; BRAIN BLOOD FLOW; BRAIN CIRCULATION; BRAIN METABOLISM; BRAIN METASTASIS; CARBON DIOXIDE TENSION; CLINICAL ARTICLE; DRUG DOSE COMPARISON; DRUG MEGADOSE; GLIOBLASTOMA; HEMOGLOBIN DETERMINATION; LOW DRUG DOSE; MENINGIOMA; OXYGEN SATURATION; OXYGENATION; PRIORITY JOURNAL; SPECTROPHOTOMETRY; TEMPORAL LOBE EPILEPSY;

ADULT; AGED; ANESTHETICS, INTRAVENOUS; BLOOD FLOW VELOCITY; BRAIN; CARBON DIOXIDE; CRANIOTOMY; DOSE-RESPONSE RELATIONSHIP, DRUG; FEASIBILITY STUDIES; FEMALE; FIBER OPTIC TECHNOLOGY; GERMANY; HEMOGLOBINS; HUMANS; LASER-DOPPLER FLOWMETRY; MALE; MICROCIRCULATION; MIDDLE AGED; MONITORING, INTRAOPERATIVE; OXYGEN; PHOTOMETRY; PROPOFOL; SPECTRUM ANALYSIS;

EID: 75149191931     PISSN: 08984921     EISSN: 15371921     Source Type: Journal    
DOI: 10.1097/ANA.0b013e3181bea439     Document Type: Article

References (46)

1. Walter B, Bauer R, Krug A, et al. Simultaneous measurement of local cortical blood flow and tissue oxygen saturation by Near infrared laser Doppler flowmetry and remission spectroscopy in the pig brain. Acta Neurochir Suppl. 2002;81: 197-199.
2. 2C for the quantification of tissue ischemia in diabetic foot ulcers. Diabetes Care. 2004;27: 2863-2867.
3. Schier F, Turial S, Hückstädt T, et al. Laparoscopic inguinal hernia repair does not impair testicular perfusion. J Pediatr Surg. 2008;43: 131-135.
4. Bludau M, Vallböhmer D, Gutschow C, et al. Quantitative measurement of gastric mucosal microcirculation using a combined laser Doppler flowmeter and spectrophotometer. Dis Esophagus. 2008;21: 668-672.
5. Albuszies G, Radermacher P, Vogt J, et al. Effect of increased cardiac output on hepatic and intestinal microcirculatory blood flow, oxygenation, and metabolism in hyperdynamic murine septic shock. Crit Care Med. 2005;33: 2332-2338.
6. Brell B, Temmesfeld-Wollbrück B, Altzschner I, et al. Adrenomedullin reduces Staphylococcus aureus alpha-toxin-induced rat ileum microcirculatory damage. Crit Care Med. 2005;33: 819-826.
7. Buise MP, Ince C, Tilanus HW, et al. The effect of nitroglycerin on microvascular perfusion and oxygenation during gastric tube reconstruction. Anesth Analg. 2005;100: 1107-1111.
8. Fournell A, Scheeren TWL, Schwarte LA. Simultaneous assessment of microvascular oxygen saturation and laser-Doppler flow in gastric mucosa. Adv Exp Med Biol. 2003;540: 47-53.
9. Schwarte LA, Fournell A, van Bommel J, et al. Redistribution of intestinal microcirculatory oxygenation during acute hemodilution in pigs. J Appl Physiol. 2005;98: 1070-1075.
10. Wunder C, Brock RW, Krug A, et al. A remission spectroscopy system for in vivo monitoring of hemoglobin oxygen saturation in murine hepatic sinusoids, in early systemic inflammation. Comp Hepatol. 2005;4: 1.
11. Wunder C, Brock RW, Frantz S, et al. Carbon monoxide, but not endothelin-1, plays a major role for the hepatic microcirculation in a murine model of early systemic inflammation. Crit Care Med. 2005;33: 2323-2331.
12. Conzen PF, Hobbhahn J, Goetz AE, et al. Myocardial contractility, blood flow, and oxygen consumption in healthy dogs during anesthesia with isoflurane or enflurane. J Cardiothorac Anesth. 1989;3: 70-77.
13. Knobloch K, Lichtenberg A, Pichlmaier M, et al. Microcirculation of the sternum following harvesting of the left internal mammary artery. Thorac Cardiovasc Surg. 2003;51: 255-259.
14. Knobloch K, Lichtenberg A, Pichlmaier M, et al. Palmar microcirculation after harvesting of the radial artery in coronary revascularization. Ann Thorac Surg. 2005;79: 1026-1030.
15. Klein KU, Glaser M, Reisch R, et al. The effects of arterial carbon dioxide partial pressure and sevoflurane on capillary venous cerebral blood flow and oxygen saturation during craniotomy. Anesth Analg. 2009;109: 199-204.
16. Shepherd AP. Laser-Doppler Blood Flowmetry. Norwell, MA: Kluwer Academic Publishers; 1990.
17. Bonner R, Nossal R. Model for laser Doppler measurements of blood flow in tissue App. Opt. 1981;20: 2097-2107.
18. Frank KH, Kessler M, Appelbaum K, et al. The Erlangen micro-lightguide spectrophotometer EMPHO I. Phys Med Biol. 1989;34: 1883-1900.
19. Mook GA, van Assendelft OW, Zijlstra WG. Wavelength dependency of the spectrophotometric determination of blood oxygen saturation. Clin Chim Acta. 1969;26: 170-173.
20. Zijlstra WG, Buursma A, Meeuwsen-van der Roest WP. Absorption spectra of human fetal and adult oxyhemoglobin, de-oxyhemoglobin, carboxyhemoglobin, and methemoglobin. Clin Chem. 1991;37: 1633-1638.
21. Serianni R, Barash J, Bentley T, et al. Porcine-specific hemoglobin saturation measurements. J Appl Physiol. 2003;94: 561-566.
22. Kety SS, Schmidt CF. The effects of altered arterial tensions of carbon dioxide and oxygen on cerebral blood flow and cerebral oxygen consumption of normal young men. J Clin Invest. 1948;27: 484-492.
23. Schaller B. Physiology of cerebral venous blood flow: from experimental data in animals to normal function in humans. Brain Res Brain Res Rev. 2004;46: 243-260.
24. Bereczki D, Wei L, Otsuka T, et al. Hypercapnia slightly raises blood volume and sizably elevates flow velocity in brain microvessels. Am J Physiol. 1993;264: H1360-H1369.
25. Hudetz AG. Blood flow in the cerebral capillary network: a review emphasizing observations with intravital microscopy. Microcirculation. 1997;4: 233-252.
26. Hemphill JC, Knudson MM, Derugin N, et al. Carbon dioxide reactivity and pressure autoregulation of brain tissue oxygen. Neurosurgery. 2001;48: 377-383.
27. Jackson SA, Piper I, Dunn L, et al. Assessment of the variation in cerebrovascular reactivity in head injured patients. Acta Neurochir Suppl. 2000;76: 445-449.
28. Kadoi Y, Takahashi K, Saito S, et al. The comparative effects of sevoflurane versus isoflurane on cerebrovascular carbon dioxide reactivity in patients with diabetes mellitus. Anesth Analg. 2006;103: 168-172.
29. 2 vasoreactivity: association with endothelial dysfunction. Am J Physiol Heart Circ Physiol. 2006;291: 1856-1861.
30. Jadhav V, Solaroglu I, Obenaus A, et al. Neuroprotection against surgically induced brain injury. Surg Neurol. 2007;67: 15-20.
31. 2-reactivity and autoregulation in patients with post-traumatic diffuse brain swelling (diffuse injury III). Acta Neurochir Suppl. 1998;71: 233-236.
32. Verweij BH, Amelink GJ, Muizelaar JP. Current concepts of cerebral oxygen transport and energy metabolism after severe traumatic brain injury. Prog Brain Res. 2007;161: 111-124.
33. 2 and relative Hb concentration in the human brain-a study with the Erlangen micro-lightguide spectrophotometer (EMPHO). Physiol Meas. 1994;15: 107-113.
34. Meyer B, Schaller C, Frenkel C, et al. Distributions of local oxygen saturation and its response to changes of mean arterial blood pressure in the cerebral cortex adjacent to arteriovenous malformations. Stroke. 1999;30: 2623-2630.
35. 2 reactivity testing in the vicinity of cerebral arteriovenous malformations. Stroke. 2003;34: 938-944.
36. Lennox WG, Gibbs EL. The blood flow in the brain and the leg of man, and the changes induced by alteration of blood gases. J Clin Invest. 1932;11: 1155-1177.
37. Kuschinsky W, Paulson OB. Capillary circulation in the brain. Cerebrovasc Brain Metab Rev. 1992;4: 261-286.
38. 2 reactivity of brain vessels in the human. Anaesthesist. 1987;36: 60-65.
39. Vandesteene A, Trempont V, Engelman E, et al. Effect of propofol on cerebral blood flow and metabolism in man. Anaesthesia. 1988;43(suppl): 42-43.
40. Gelb AW, Zhang C, Hamilton JT. Propofol induces dilation and inhibits constriction in guinea pig basilar arteries. Anesth Analg. 1996;83: 472-476.
41. Shibuya K, Ishiyama T, Ichikawa M, et al. The direct effects of propofol on pial microvessels in rabbits. J Neurosurg Anesthesiol. 2009;21: 40-46.
42. Artru AA, Shapira Y, Bowdle TA. Electroencephalogram, cerebral metabolic, and vascular responses to propofol anesthesia in dogs. J Neurosurg Anesthesiol. 1992;4: 99-109.
43. Iwakiri H, Nishihara N, Nagata O, et al. Individual effect-site concentrations of propofol are similar at loss of consciousness and at awakening. Anesth Analg. 2005;100: 107-110.
44. Kaisti KK, Langsjo JW, Aalto S, et al. Effects of sevoflurane, propofol, and adjunct nitrous oxide on regional cerebral blood flow, oxygen consumption, and blood volume in humans. Anesthesiology. 2003;99: 603-613.
45. Alkire MT, Haier RJ, Barker SJ, et al. Cerebral metabolism during propofol anesthesia in humans studied with positron emission tomography. Anesthesiology. 1995;82: 393-403.
46. 2 measurements. Eur Surg Res. 2008;40: 47-54.