Journal of Clinical Monitoring and Computing

, Volume 28, Issue 3, pp 319–323

The use of regional cerebral oximetry monitoring during controlled hypotension: a case series

  • Brandon A. Van Noord
  • Christopher L. Stalker
  • Peter Roffey
  • Duraiyah Thangathurai
Brief Report

DOI: 10.1007/s10877-013-9523-9

Cite this article as:
Van Noord, B.A., Stalker, C.L., Roffey, P. et al. J Clin Monit Comput (2014) 28: 319. doi:10.1007/s10877-013-9523-9
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Abstract

Regional cerebral oximetry monitoring was used to guide nitroglycerin infusion and IV fluid administration during controlled hypotension in order to optimize each individual patient’s mean arterial pressure in a series of 20 consecutive patients who underwent major open urological or abdominal surgery. Although controlled hypotension offers a definite benefit in patients undergoing complex surgery where blood loss will be elevated or would severely compromise the surgical field, it is not without risk as low arterial pressure may compromise tissue perfusion and promote ischemia. In this case series, despite an average mean arterial pressure decrease of 19.5 % (p < 0.001), cerebral oximetry values increased by an average of 22.7 % (p < 0.001) after the nitroglycerin infusion had been initiated (220 mcg/min average). Patients received an average of 3.15L crystalloid and 437 ml albumin in fluid resuscitation.

Keywords

Controlled hypotensionNitroglycerinCerebral oximetry

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Brandon A. Van Noord
    • 1
    • 2
  • Christopher L. Stalker
    • 1
  • Peter Roffey
    • 1
  • Duraiyah Thangathurai
    • 1
  1. 1.Department of Anesthesia, Keck Medical CenterUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Department of AnesthesiologyLAC+USC Medical CenterLos AngelesUSA