Cerebral oxygenation in health and disease.

Patrice Brassard,Philip N Ainslie,Niels H Secher

doi:10.3389/fphys.2014.00458

Patrice Brassard, Philip N Ainslie + Show 1 more

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https://doi.org/10.3389/fphys.2014.00458

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Abstract

Monitoring cerebral blood flow (CBF) and oxygenation has implications for both clinical practice and research interests; e.g., to provide insight into functional neurovascular coupling, to better understand orthostatic hypotension, and to evaluate the influence of vasopressors on cerebral oxygenation during anesthesia and/or surgery. These topics, and others, are addressed in this e-book by presenting original research, reviews, and opinion papers covering new, exciting but also controversial issues related to cerebral oxygenation in health and disease as evaluated by near-infrared spectroscopy (NIRS).

Highlights

Monitoring cerebral blood flow (CBF) and oxygenation has implications for both clinical practice and research interests; e.g., to provide insight into functional neurovascular coupling, to better understand orthostatic hypotension, and to evaluate the influence of vasopressors on cerebral oxygenation during anesthesia and/or surgery
A reduction in ScO2 is reported with use of phenylephrine and noradrenaline at rest in healthy subjects, during anesthesia in non-cardiac and cardiac patients and during cardiopulmonary bypass in diabetics
Possible extracranial contamination of the near-infrared spectroscopy (NIRS) signal, especially with the utilization of vasopressors, challenges these conclusions. Keeping this limitation in mind, Foss et al (2014) explored the influence of phenylephrine and ephedrine, on ScO2 during cesarean section with spinal anesthesia. Both vasopressors were effective at maintaining mean arterial pressure (MAP)

Summary

Introduction

Monitoring cerebral blood flow (CBF) and oxygenation has implications for both clinical practice and research interests; e.g., to provide insight into functional neurovascular coupling, to better understand orthostatic hypotension, and to evaluate the influence of vasopressors on cerebral oxygenation during anesthesia and/or surgery. A reduction in ScO2 is reported with use of phenylephrine and noradrenaline at rest in healthy subjects, during anesthesia in non-cardiac and cardiac patients and during cardiopulmonary bypass in diabetics. Kitchen et al (2014) studied the effect of calcium chloride compared to α- and β-adrenergic receptor agonists (ephedrine, phenylephrine, adrenaline, or noradrenaline) following anesthesia-induced hypotension in patients scheduled for major abdominal surgery.

Results

Conclusion