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Journal of Clinical Monitoring and Computing

, Volume 29, Issue 5, pp 613–619 | Cite as

Utility of near infrared light to determine tissue oxygenation during hepato-biliary surgery

  • N. Murphy
  • S. Fröhlich
  • T. Kong
  • J. F. Boylan
  • N. Conlon
Original Research

Abstract

Near-infrared spectrophotometry assesses cerebral oxygen saturation (ScO2) based on the absorption spectra of oxygenated and deoxygenated hemoglobin, and the translucency of biological tissue, in the near-infrared band. There is increasing evidence that optimising cerebral oxygenation, guided by ScO2, is associated with improved outcomes in a variety of high risk surgical settings. However, in patients with liver disease, bilirubin can potentially render cerebral oximetry inaccurate. As a result, measurement of cerebral oxygen saturation is rarely undertaken in patients undergoing hepatobiliary surgery. We prospectively measured baseline and intraoperative cerebral oxygen saturation in patients undergoing major pancreatic surgery. Indices including bilirubin, sodium, platelets and maximum amplitude on thromboelastography were associated with low baseline ScO2. However, those patients with low ScO2 (≤51 %) maintained a similar trend in cerebral oximetry values both at induction and intraoperatively to those with a normal ScO2. We conclude that the pattern of cerebral oximetry is similar in patients undergoing major pancreatic surgery regardless of their underlying liver dysfunction. Therefore, cerebral oximetry may have a role in monitoring neurological function in this high risk group of patients.

Keywords

Cerebral oximetry Bilirubin Liver Hepatobiliary 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • N. Murphy
    • 1
  • S. Fröhlich
    • 1
  • T. Kong
    • 2
  • J. F. Boylan
    • 1
  • N. Conlon
    • 1
  1. 1.Department of Anaesthesia and Intensive Care MedicineSt Vincent’s University HospitalDublin 4Ireland
  2. 2.Department of Anaesthesia and Intensive Care MedicineGalway University HospitalGalwayIreland

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