Advertisement

Re-Evaluation of the Reliability of Cytochrome Oxidase—Signal Study of Cardiopulmonary Bypass

  • Yasuyuki Kakihana
  • Tamotsu Kuniyoshi
  • Sumikazu Isowaki
  • Kazumi Tobo
  • Etsuro Nagata
  • Naoko Okayama
  • Kouichirou Kitahara
  • Takahiro Moriyama
  • Takeshi Omae
  • Masayuki Kawakami
  • Yuichi Kanmura
  • Mamoru Tamura
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 540)

Abstract

The monitoring of brain oxygen status using near-infrared spectroscopy (NIRS) has recently been applied to clinical practice in the field of cardiovascular surgery. Published studies have indicated that NIRS could be used as a continuous and noninvasive way of observing changes in the cerebral oxygenation state during hypoxia and ischemia, since changes occur in optical properties under these conditions. However, the interpretation of NIRS data, especially the cytochrome oxidase (cyt. ox.) signal, remains controversial. A possible source of error that might interfere with the accurate measurement of the redox state of cyt. ox. derives from an overlapping of the absorption spectra for hemoglobin and cyt. ox. in the near-infrared region, with the absorption coefficient for hemoglobin being an order of magnitude greater than that for cyt. ox.. Recently, it was reported that the cyt. ox. signal measured by near-infrared spectroscopy (NIRS) is highly contaminated with the hemoglobin signal [1]. However, the cyt. ox. signal measured by NIRS would be expected to be strongly dependent on the algorithm employed. We have developed a new approach to the measurement of the redox state of cyt. ox. in the brain involving the use of a new algorithm [2], which has already been employed in clinical medicine [3, 4]. Therefore, in this paper we looked for evidence of cross-talk between the cytochrome and hemoglobin (Hb) signals when our new algorithm was used under cardiopulmonary bypass (CPB) in a dog model. Furthermore, we retrospectively studied the relationship between data obtained concerning the redox behavior of cyt. ox. during surgery (again using our new algorithm) and neurological prognosis in 105 patients.

Keywords

Cardiopulmonary Bypass Cytochrome Oxidase Light Guide Redox Behavior Thoracic Aortic Aneurysm 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sakamoto T, Jonas RA, Stock UA, et al: Utility and limitations of near-infrared spectroscopy during cardiopulmonary bypass in a piglet model. Pediatr. Res. 2001; 49: 770–776.PubMedCrossRefGoogle Scholar
  2. 2.
    Hoshi Y, Hazeki O, Kakihana Y, Tamura M: Redox behavior of cytochrome oxidase in the rat brain measured by near-infrared spectroscopy. J Appl Physiol 1997; 83: 1842–1848.PubMedGoogle Scholar
  3. 3.
    Kakihana Y, Matsunaga A, Tobo K, Isowaki S, Kawakami M, Tsuneyoshi I, Kanmura Y, Tamura M. Redox behavior of cytochrome oxidase and neurological prognosis in 66 patients who underwent thoracic aortic surgery. Eur J Cardiothorac Surg 2002; 21: 434–439PubMedCrossRefGoogle Scholar
  4. 4.
    Kuroda S, Houkin K, Abe H, Hoshi Y, Mamoru T. Near-infrared monitoring of cerebral oxygenation state during carotid endarterectomy. Surg Neurol 1996; 45: 450–458.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Yasuyuki Kakihana
    • 1
  • Tamotsu Kuniyoshi
  • Sumikazu Isowaki
  • Kazumi Tobo
  • Etsuro Nagata
  • Naoko Okayama
  • Kouichirou Kitahara
  • Takahiro Moriyama
  • Takeshi Omae
  • Masayuki Kawakami
  • Yuichi Kanmura
  • Mamoru Tamura
    • 2
  1. 1.Division of Intensive Care MedicineKagoshima University HospitalKagoshimaJapan
  2. 2.Biophysics Group, Research Institute for Electronic ScienceHokkaido UniversityKita-ku, Sapporo 060Japan

Personalised recommendations