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Zerebrale Oxymetrie

Klinischer Stellenwert bei kardiochirurgischen Patienten

Cerebral oximetry

Clinical importance for cardiac surgery patients

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Zusammenfassung

Die Bestimmung der zerebralen Sauerstoffsättigung (SO2) mithilfe der Nahinfrarotspektroskopie (NIRS) erlaubt auf nichtinvasivem Weg eine Aussage über das Verhältnis von zerebralem Sauerstoffangebot und -bedarf im Bereich des frontalen Kortex. Untersuchungen an herz- und nichtherzchirurgischen Patienten konnten herausarbeiten, dass die Aufrechterhaltung der zerebralen SO2 im Bereich der präoperativen Ausgangslage die Inzidenz postoperativer kognitiver Dysfunktion und allgemeiner Morbidität reduziert. Die zerebrale SO2 reflektiert aber nicht nur die zerebrale, sondern auch die systemische Sauerstoffbalance, steht im Zusammenhang mit der kardiopulmonalen Funktion und hat bei herzchirurgischen Patienten prognostische Relevanz. Somit scheint dieses Verfahren sowohl zum neurologischen als auch zum hämodynamischen Monitoring und zur präoperativen Risikostratifizierung herzchirurgischer Patienten geeignet zu sein.

Abstract

The determination of cerebral oxygen saturation (ScO2) by means of near-infrared spectroscopy allows non-invasive assessment of the cerebral oxygen delivery and demand ratio in the frontal cortex region. Studies in cardiac as well as non-cardiac patients have shown that maintaining ScO2 in the preoperative range reduces the incidence of postoperative cognitive dysfunction and general morbidity; however, ScO2 is not only reflective of cerebral but also of systemic oxygen balance, is inversely related to cardiopulmonary function and has prognostic relevance in cardiac surgery patients. This suggests that cerebral oximetry is not only useful for neurological but also for hemodynamic monitoring and preoperative risk stratification of cardiac surgery patients.

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Interessenkonflikt

Der korrespondierende Autor weist für sich und seine Koautoren auf folgende Beziehungen hin: Die Autoren Julika Schön und Matthias Heringlake erhalten Forschungsunterstützung sowie Vortragshonorare von Covidien, dem Hersteller des INVOS® Zerebraloxymeters.

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  1. Klinik für Anaesthesiologie und Intensivmedizin, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    J. Schön, H. Paarmann &  M. Heringlake

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  1. J. Schön
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  2. H. Paarmann
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  3. M. Heringlake
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Correspondence to M. Heringlake.

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Schön, J., Paarmann, H. & Heringlake, M. Zerebrale Oxymetrie. Anaesthesist 61, 934–940 (2012). https://doi.org/10.1007/s00101-012-2066-5

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  • DOI: https://doi.org/10.1007/s00101-012-2066-5

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