JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Nielsen, H. B. Articles by Børglum, J. Search for Related Content PubMed PubMed Citation Articles by Nielsen, H. B. Articles by Børglum, J.

---

LETTER TO THE EDITOR

Cerebral Oxygenation in Heart Surgery

Department of Thoracic Anesthesia; University of Copenhagen, Rigshospitalet; Copenhagen, Denmark; hbay{at}vip.cybercity.dk

To the Editor:

Recently, Murkin et al. (1) assessed brain oxygen saturation during coronary bypass surgery. With a simple protocol to optimize perfusion the authors conclude that monitoring cerebral oxygenation during a coronary bypass induces a significantly smaller incidence of major organ dysfunction postoperatively. The experience with using near-infra spectroscopy during coronary bypass is that immediately after the start of the heart lung machine some subjects exhibit a marked reduction in cerebral oxygenation, whereas in other subjects independently of cardiac index cerebral oxygenation is unchanged. However, the paper fails to address a few concerns important for interpretation of the data. First, the authors describe that if cardiac index was <2.0 L · m^–2· min^–1 the pump flow was increased to 2.5 L · m^–2 · min^–1. Therefore, was cardiac index similar in the two groups? Second, what was the pump flow value before it increased? Could it be that the significant difference in outcome between the two groups relate to that pump flow was too low in the control group? Certainly, the change in cerebral oxygenation in the two groups was almost nonsignificant and therefore the data opens for the question—do we need to record cerebral oxygenation? Rather than increased cerebral oxygenation was the effect of intervention related to increased inspired O₂ fraction? With the vague conclusion that monitoring of cerebral oxygenation avoids organ dysfunction, it appears to be the same problem as with the Swan Gantz catheter. It may be a challenge to select the population in whom cerebral oxygenation needs to be optimized.

REFERENCE

1. Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, Cleland A, Schaefer B, Irwin B, Fox S. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg 2007;104:51–8[Abstract/Free Full Text]

This article has been cited by other articles:

				J. M. Murkin, D. Bainbridge, and R. Novick Adequacy of Brain Oxygen Saturation for Goal-Directed Therapy Anesth. Analg., August 1, 2007; 105(2): 538 - 539. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Nielsen, H. B. Articles by Børglum, J. Search for Related Content PubMed PubMed Citation Articles by Nielsen, H. B. Articles by Børglum, J.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999