Mechanism of injury, associated outcome and intervention

Learn more about system hypoxia causing cerebral desaturation:

Mechanism of Injury

  • Pulse oximetry may be unreliable under cardiopulmonary bypass and circulatory arrest.([FOOTNOTE=Sessler DI. Pulse oximetry may not reliably assess peripheral perfusion. Anesthesiology. 1998;88(4):1129; author reply 1130.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=883118]) Therefore, system hypoxia may be difficult to diagnose.
  • Because cerebral oximetry does not depend on pulsatile flow, it may be used to confirm the presence of hypoxemia([FOOTNOTE=Shah N, Trivedi NK, Clack SL, Shah M, Shah PP, Barker S. Impact of hypoxemia on the performance of cerebral oximeter in volunteer subjects. Journal of neurosurgical anesthesiology. 2000;12(3):201-209.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=883088])
  • Adjusting FiO2 from 30% to 100% in shunted and non-shunted patients undergoing carotid endarterectomy significantly increased regional cerebral oxygen saturation([FOOTNOTE=Picton P, Chambers J, Shanks A, Dorje P. The influence of inspired oxygen fraction and end-tidal carbon dioxide on post-cross-clamp cerebral oxygenation during carotid endarterectomy under general anesthesia. Anesth Analg. 2010;110(2):581-587.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=883087])

Associated Outcome

  • A retrospective study of adverse perfusion-related incidents during cardiopulmonary bypass determined that 6% of incidents were the results of failure of oxygen delivery([FOOTNOTE=Mejak BL, Stammers A, Rauch E, Vang S, Viessman T. A retrospective study on perfusion incidents and safety devices. Perfusion. 2000;15(1):51-61.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=883112])
Intervention % of all interventions([FOOTNOTE=Deschamps A, Lambert J, Couture P, et al. Reversal of decreases in cerebral saturation in high-risk cardiac surgery. Journal of cardiothoracic and vascular anesthesia. 2013;27(6):1260-1266.],[ANCHOR=View Abstract],[LINK=/content/mitg/websites/languagemasters/emea/en-gb/support/clinical-evidence.html?id=805152])
Increase inspired oxygen concentration 6

Medtronic Respiratory & Monitoring Solutions EMEA