CEA術中の脳酸素飽和度持続モニタリングによる脳循環動態の検出

概要

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We examined values of jugular bulb venous oxygen saturation (SjO_2) and regional oxygen saturation (rSO_2) in addition to electroencephalogram (EEG) monitoring to detect cerebral ischemia during carotid clamping in patients undergoing carotid endarterectomy (CEA). We summarize our finding based on a consecutive series of 10 patients. Six patients had unilateral lesion, and the remaining 4 patients had bilateral lesion or tandem lesion. We encountered cerebral ischemia, which was defined by EEG slowing, during carotid clamping in 2 patients. These patients demonstrated a concomitant decrease in rSO_2 to 64% and 52%, respectively: a 10% decrease compared to the pre-clamping baseline in both patients. Contrarily, the SjO_2 was maintained at almost the same level with that of pre-clamping. These results suggest that SjO_2 is not sufficiently sensitive to detect cerebral ischemia during CEA. Continuous monitoring of rSO_2 is adequately sensitive to detect cerebral ischemia, and 10% decrease in rSO2 may indicate cerebral ischemia.
日本脳卒中の外科学会の論文
2001-07-31