Cirrhotic patients in icu with gastro-intestinal bleeding managed according to recent guidelines display altered brain hemoglobin oxygen’s saturation assessed by near infrared spectroscopy
نویسندگان
چکیده
Introduction Near Infrared Spectroscopy (NIRS) is a non-invasive optical technique allowing a continuous measurement of brain’s hemoglobin saturation in oxygen (rSO2). It is considered as a surrogate marker of cerebral insult, and recognized as a useful tool in in cardiovascular surgery and neuromonitoring. A rSO2< 50% is associated with increased neurological impairment and post-operative mortality. In cirrhotic patients with gastrointestinal bleeding (GIB), hemoglobin (Hb) threshold for transfusion has been recently lowered to 7 g/dL. Some patients develop hepatic encephalopathy (HE) after GIB. In subarachnoid hemorrhage, a threshold of 7 g/dL of Hb could worsen neurological outcome.
منابع مشابه
Regional cerebrovascular oxygen saturation measured by optical spectroscopy in humans.
Regional cerebrovascular oxygen saturation, a quantitative measure of hemoglobin saturation in the combined arterial, venous, and microcirculatory compartments of the brain, can be measured noninvasively with near infrared spectroscopy. We assessed the sensitivity of this aggregate saturation to cerebral hypoxia during transient cerebral hypoxic hypoxia in seven human subjects. Regional cerebro...
متن کاملOptical Imaging of the Motor Cortex in the Brain in Order to Determine the Direction of the Hand Movements Using Functional Near-Infrared Spectroscopy (fNIRS)
Introduction: In recent years, optical imaging has attracted a lot of attention from scholars as a non- aggressive, efficient method for evaluating the activities of the motor cortex in the brain. Functional near-infrared spectroscopy (fNIRS (is a tool showing the hemodynamic changes in a cortical area of the brain according to optical principles. The present study has been de...
متن کاملStudy protocol for the PHANTOM study: prehospital assessment of noninvasive tissue oximetry monitoring
BACKGROUND Traumatic brain injury is a major cause of mortality and morbidity worldwide. It can be worsened by secondary injury particularly with hypoxia or hypotension. Current prehospital guidelines emphasise regular measurement of peripheral oxygen saturation and blood pressure but there is no monitor in use to provide direct information relating to blood flow or oxygen delivery to the brain...
متن کاملBilateral near-infrared monitoring of the cerebral concentration and oxygen-saturation of hemoglobin during right unilateral electro-convulsive therapy.
Reductions in right prefrontal cerebral blood flow have been correlated with symptomatic improvement in depressed individuals receiving electroconvulsive therapy (ECT). Non-invasive near infrared spectroscopy has previously been shown to reliably measure changes in cerebral hemoglobin concentrations and oxygen saturation. In this study, we measured the concentration and oxygen saturation of hem...
متن کاملReduced cortical microvascular oxygenation in multiple sclerosis: a blinded, case-controlled study using a novel quantitative near-infrared spectroscopy method
Hypoxia (low oxygen) is associated with many brain disorders as well as inflammation, but the lack of widely available technology has limited our ability to study hypoxia in human brain. Multiple sclerosis (MS) is a poorly understood neurological disease with a significant inflammatory component which may cause hypoxia. We hypothesized that if hypoxia were to occur, there should be reduced micr...
متن کامل