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Cerebral oxygen saturation, transcranial Doppler ultrasonography and stump pressure in carotid surgery

Authors :
Williams, I M
Vohra, R
Farrell, A
Picton, A J
Mortimer, A J
McCollum, C N
Source :
British Journal of Surgery; July 1994, Vol. 81 Issue: 7 p960-964, 5p
Publication Year :
1994

Abstract

Transcranial Doppler ultrasonography (TCD) of the middle cerebral artery (MCA), light-reflective cerebral oximetry and measurement of internal carotid artery stump pressure were compared as methods of monitoring cerebral perfusion during carotid surgery in 33 patients. Median cerebral oxygen saturation was 70 (range 62–85) per cent and TCD-measured mean blood velocity 42 (range 19–91) cm/s before carotid cross-clamping, falling to 68 (53–83) per cent and 16 (0–50) cm/s respectively on application of the clamps (P< 0·001). Stump pressure correlated closely with MCA blood velocity 30 s after the start of cross-clamping (rs= 0·58, P< 0·001), but not with cerebral oxygen saturation. A fall of 5 per cent or more in cerebral oxygen saturation following cross-clamp application was predicted by a decrease in mean MCA blood velocity of at least 60 per cent. Changes in cerebral oxygen saturation correlated significantly with systolic blood pressure throughout the perioperative period (rs= 0·41, P< 0·001). Significant falls in cerebral oxygenation were not predicted by low stump pressure but were associated with large reductions in the mean MCA blood velocity measured by TCD.

Details

Language :
English
ISSN :
00071323 and 13652168
Volume :
81
Issue :
7
Database :
Supplemental Index
Journal :
British Journal of Surgery
Publication Type :
Periodical
Accession number :
ejs67518224
Full Text :
https://doi.org/10.1002/bjs.1800810711