Issue |
J Extra Corpor Technol
Volume 55, Number 4, December 2023
|
|
---|---|---|
Page(s) | 209 - 217 | |
DOI | https://doi.org/10.1051/ject/2023032 | |
Published online | 15 December 2023 |
Review Article
Our initial experience of monitoring the autoregulation of cerebral blood flow during cardiopulmonary bypass
1
Heart Centre, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
2
Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, 901 87 Umeå, Sweden
* Corresponding author: staffan.svenmarker@umu.se
Received:
25
January
2023
Accepted:
5
July
2023
Background: Cerebral blood flow (CBF) is believed to be relatively constant within an upper and lower blood pressure limit. Different methods are available to monitor CBF autoregulation during surgery. This study aims to critically analyze the application of the cerebral oxygenation index (COx), one of the commonly used techniques, using a reference to data from a series of clinical registrations. Method: CBF was monitored using near-infrared spectroscopy, while cerebral blood pressure was estimated by recordings obtained from either the radial or femoral artery in 10 patients undergoing cardiopulmonary bypass. The association between CBF and blood pressure was calculated as a moving continuous correlation coefficient. A COx index > 0.4 was regarded as a sign of abnormal cerebral autoregulation (CA). Recordings were examined to discuss reliability measures and clinical feasibility of the measurements, followed by interpretation of individual results, identification of possible pitfalls, and suggestions of alternative methods. Results and Conclusion: Monitoring of CA during cardiopulmonary bypass is intriguing and complex. A series of challenges and limitations should be considered before introducing this method into clinical practice.
Key words: Cardiopulmonary bypass / Monitoring / Cerebral blood flow / Autoregulation / Near-infrared spectroscopy
© The Author(s), published by EDP Sciences, 2023
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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