Your browser doesn't support javascript.
loading
Correlation of Cerebral Microdialysis with Non-Invasive Diffuse Optical Cerebral Hemodynamic Monitoring during Deep Hypothermic Cardiopulmonary Bypass.
Ko, Tiffany S; Mavroudis, Constantine D; Benson, Emilie J; Forti, Rodrigo M; Melchior, Richard W; Boorady, Timothy W; Morano, Vincent C; Mensah-Brown, Kobina; Lin, Yuxi; Aronowitz, Danielle; Starr, Jonathan P; Rosenthal, Tami M; Shade, Brandon C; Schiavo, Kellie L; White, Brian R; Lynch, Jennifer M; Gaynor, J William; Licht, Daniel J; Yodh, Arjun G; Baker, Wesley B; Kilbaugh, Todd J.
Afiliación
  • Ko TS; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Mavroudis CD; Division of Cardiothoracic Surgery, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Benson EJ; Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Forti RM; Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104, USA.
  • Melchior RW; Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Boorady TW; Division of Perfusion Services, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Morano VC; Geisinger Commonwealth School of Medicine, Scranton, PA 18510, USA.
  • Mensah-Brown K; Department of Physics and Astronomy, Johns Hopkins University, Baltimore, MD 21218, USA.
  • Lin Y; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
  • Aronowitz D; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Starr JP; Division of Cardiothoracic Surgery, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Rosenthal TM; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Shade BC; Division of Perfusion Services, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Schiavo KL; Division of Perfusion Services, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • White BR; Division of Perfusion Services, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Lynch JM; Department of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Gaynor JW; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Licht DJ; Division of Cardiothoracic Surgery, Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Yodh AG; Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
  • Baker WB; Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104, USA.
  • Kilbaugh TJ; Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Metabolites ; 12(8)2022 Aug 10.
Article en En | MEDLINE | ID: mdl-36005609
Neonates undergoing cardiac surgery involving aortic arch reconstruction are at an increased risk for hypoxic-ischemic brain injury. Deep hypothermia is utilized to help mitigate this risk when periods of circulatory arrest are needed for surgical repair. Here, we investigate correlations between non-invasive optical neuromonitoring of cerebral hemodynamics, which has recently shown promise for the prediction of postoperative white matter injury in this patient population, and invasive cerebral microdialysis biomarkers. We compared cerebral tissue oxygen saturation (StO2), relative total hemoglobin concentration (rTHC), and relative cerebral blood flow (rCBF) measured by optics against the microdialysis biomarkers of metabolic stress and injury (lactate-pyruvate ratio (LPR) and glycerol) in neonatal swine models of deep hypothermic cardiopulmonary bypass (DHCPB), selective antegrade cerebral perfusion (SACP), and deep hypothermic circulatory arrest (DHCA). All three optical parameters were negatively correlated with LPR and glycerol in DHCA animals. Elevation of LPR was found to precede the elevation of glycerol by 30-60 min. From these data, thresholds for the detection of hypoxic-ischemia-associated cerebral metabolic distress and neurological injury are suggested. In total, this work provides insight into the timing and mechanisms of neurological injury following hypoxic-ischemia and reports a quantitative relationship between hypoxic-ischemia severity and neurological injury that may inform DHCA management.
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Metabolites Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Prognostic_studies Idioma: En Revista: Metabolites Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza