Cerebral microembolic load in open heart surgery with different extracorporeal circulation systems

Abstract

Somanetics 5100C was used to assess regional tissue oxygen saturation. DO2 and VO2 values to assess the oxygen delivery and consumption were also calculated. The association between cerebral and somatic rSO2 trends and mean arterial pressure, pump flow and blood gases were also studied. Results. it was found that prolonged episodes of decrease of somatic rSO2 during cardiopulmonary bypass with lower haemoglobin levels and DO2 values were strongly associated with occurrence of post-op organ disorders especially acute kidney injury. As the results of the correspondence analysis it was shown that for positive outcome without organ disorders greater importance have absolute values of DO2, VO2 and rSO2 (both cerebral and somatic), but for the poor outcome with complications the length of episodes of rSO2 decrease has the greater influence. It was also found that somatic rSO2 values are not strongly associated with pump flow or mean arterial pressure or arterial pO2. Discussion. the use of continuous monitoring of cerebral and even somatic rSO2 during cardiopulmonary bypass in adults may help the prefusionist to assess the adequacy of tissue oxygenation. To improve the somatic and cerebral rSO2 complex strategy is needed to be worked out because the routine increase of pump or gas flow was shown to be not enough and sometimes controversial [2].