Abstract：
PURPOSE:During intracranial aneurysm surgery, numerous factors may alter cerebral blood flow and oxygen supply-demand balance. Continuous monitoring of jugular bulb venous oxygen saturation (SvjO2) may help in the anesthetic management of such procedures. MATERIALS AND METHODS:Fiberoptic SvjO2 was continuously monitored in seven patients during intracranial aneurysm surgery. Fiberoptic SvjO2 measurement was compared with IL3 CO-OXIMETER determination from 85 paired samples. The occurrence of large SvjO2 variations (SvjO2 variation reaching 10% or more of stable preceding value) during aneurysm surgery was recorded and classified according to the association or not with systemic clinical or therapeutic changes. RESULTS:Fiberoptic SvjO2 showed a limited accuracy, with limits of agreement with IL3 CO-OXIMETER at -16.8% and +10.7% and a small bias (-3.1%). SvjO2 variations were frequent during aneurysm surgery, ranging from 3 to 22 per patient during procedures lasting 6 hours (range 4.5 to 7). Half of these variations occurred in the absence of any systemic clinical or therapeutic change, most often leading to an increased SvjO2. CONCLUSIONS:Although the accuracy of fiberoptic SvjO2 determination is limited, it allows the detection of cerebral blood flow and oxygen supply-demand imbalance during aneurysm surgery. The frequent occurrence of SvjO2 elevations is suggestive of reactive hyperemia mechanisms.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Clavier N,Schurando P,Raggueneau JL,Payen DMdoi
10.1016/s0883-9441(97)90040-xsubject
Has Abstractpub_date
1997-09-01 00:00:00pages
112-9issue
3eissn
0883-9441issn
1557-8615pii
S0883-9441(97)90040-Xjournal_volume
12pub_type
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