Yves Collin1,2, Tina Hu3,4, André Denault3,5, Annik Fortier6, William Beaubien-Souligny7, Réal Lapointe1, Franck Vandenbroucke-Menu1. 1. Department of Hepatobiliary-Pancreatic Surgery and Transplantation, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada. 2. Division of General Surgery, Department of Surgery, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada. 3. Intensive Care Unit, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada. 4. Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 5. Department of Anesthesiology and Intensive Care Unit, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada. 6. Montreal Health Innovations Coordinating Center (MHICC), Montreal Heart Institute, Montreal, QC, Canada. 7. Division of Nephrology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Abstract
BACKGROUND: Cerebral oximetry using near-infrared spectroscopy (NIRS) is used for monitoring cerebral oxygen saturation during cardiac surgery and is correlated with clinical outcomes. Our goal was to explore cerebral and somatic NIRS in liver resections as a predictor of post-operative complications. METHODS: Prospective observational and non-interventional study from a tertiary care university hospital including adult patients undergoing liver resection monitored using NIRS at four sites before and during surgery. Those sites were: frontotemporal left and right zones, right thigh, and right arm. Anesthesiologists and surgeons were blinded to oximetry values. Correlations were assessed between baseline oximetry values and cerebro-somatic desaturation load (threshold of 80% from baseline) values with peri-operative events and complications. RESULTS: Ninety patients were distributed equally among gender with a mean age of 59.7 ± 13.1 years. Lower baseline cerebral and/or somatic values were associated with increased risk of delirium, respiratory failure, surgical and renal complications, blood transfusions, and length of stay in the intensive care unit and in the hospital (P < 0.05). The severity of somatic desaturation below 80% was the only parameter associated with blood losses (P = 0.030) and length of hospital stay (P = 0.047). CONCLUSIONS: Cerebral and somatic desaturation does occur in liver resection and can be used simultaneously during liver surgery. Both baseline cerebral and somatic NIRS values are correlated with complications and outcomes. However, thigh desaturation appears more sensitive than cerebral NIRS values in predicting some of these complications.
BACKGROUND: Cerebral oximetry using near-infrared spectroscopy (NIRS) is used for monitoring cerebral oxygen saturation during cardiac surgery and is correlated with clinical outcomes. Our goal was to explore cerebral and somatic NIRS in liver resections as a predictor of post-operative complications. METHODS: Prospective observational and non-interventional study from a tertiary care university hospital including adult patients undergoing liver resection monitored using NIRS at four sites before and during surgery. Those sites were: frontotemporal left and right zones, right thigh, and right arm. Anesthesiologists and surgeons were blinded to oximetry values. Correlations were assessed between baseline oximetry values and cerebro-somatic desaturation load (threshold of 80% from baseline) values with peri-operative events and complications. RESULTS: Ninety patients were distributed equally among gender with a mean age of 59.7 ± 13.1 years. Lower baseline cerebral and/or somatic values were associated with increased risk of delirium, respiratory failure, surgical and renal complications, blood transfusions, and length of stay in the intensive care unit and in the hospital (P < 0.05). The severity of somatic desaturation below 80% was the only parameter associated with blood losses (P = 0.030) and length of hospital stay (P = 0.047). CONCLUSIONS: Cerebral and somatic desaturation does occur in liver resection and can be used simultaneously during liver surgery. Both baseline cerebral and somatic NIRS values are correlated with complications and outcomes. However, thigh desaturation appears more sensitive than cerebral NIRS values in predicting some of these complications.
Authors: Lena Bosch; Carolyn S P Lam; Lingli Gong; Siew Pang Chan; David Sim; Daniel Yeo; Fazlur Jaufeerally; Kui Toh Gerard Leong; Hean Yee Ong; Tze Pin Ng; Arthur Mark Richards; Fatih Arslan; Lieng H Ling Journal: Eur J Heart Fail Date: 2017-06-08 Impact factor: 15.534
Authors: George M Hoffman; Nancy S Ghanayem; John P Scott; James S Tweddell; Michael E Mitchell; Kathleen A Mussatto Journal: Ann Thorac Surg Date: 2016-12-21 Impact factor: 4.330
Authors: Fun-Sun F Yao; Chia-Chih A Tseng; Chee-Yueh A Ho; Serle K Levin; Pavel Illner Journal: J Cardiothorac Vasc Anesth Date: 2004-10 Impact factor: 2.628
Authors: Alain Deschamps; Richard Hall; Hilary Grocott; C David Mazer; Peter T Choi; Alexis F Turgeon; Etienne de Medicis; Jean S Bussières; Christopher Hudson; Summer Syed; Doug Seal; Stuart Herd; Jean Lambert; André Denault; Alain Deschamps; Alan Mutch; Alexis Turgeon; Andre Denault; Andrea Todd; Angela Jerath; Ashraf Fayad; Barry Finnegan; Blaine Kent; Brent Kennedy; Brian H Cuthbertson; Brian Kavanagh; Brian Warriner; Charles MacAdams; Christian Lehmann; Christine Fudorow; Christopher Hudson; Colin McCartney; Dan McIsaac; Daniel Dubois; David Campbell; David Mazer; David Neilpovitz; David Rosen; Davy Cheng; Dennis Drapeau; Derek Dillane; Diem Tran; Dolores Mckeen; Duminda Wijeysundera; Eric Jacobsohn; Etienne Couture; Etienne de Medicis; Fahad Alam; Faraj Abdallah; Fiona E Ralley; Frances Chung; Francois Lellouche; Gary Dobson; Genevieve Germain; George Djaiani; Ian Gilron; Gregory Hare; Gregory Bryson; Hance Clarke; Heather McDonald; Helen Roman-Smith; Hilary Grocott; Homer Yang; James Douketis; James Paul; Jean Beaubien; Jean Bussières; Jeremy Pridham; J N Armstrong; Joel Parlow; John Murkin; Jonathan Gamble; Kaylene Duttchen; Keyvan Karkouti; Kim Turner; Leyla Baghirzada; Linda Szabo; Manoj Lalu; Marcin Wasowicz; Michael Bautista; Michael Jacka; Michael Murphy; Michael Schmidt; Michaël Verret; Michel-Antoine Perrault; Nicolas Beaudet; Norman Buckley; Peter Choi; Peter MacDougall; Philip Jones; Pierre Drolet; Pierre Beaulieu; Ravi Taneja; Rene Martin; Richard Hall; Ronald George; Rosa Chun; Sarah McMullen; Scott Beattie; Sonia Sampson; Stephen Choi; Stephen Kowalski; Stuart McCluskey; Summer Syed; Sylvain Boet; Tim Ramsay; Tarit Saha; Thomas Mutter; Tumul Chowdhury; Vishal Uppal; William Mckay Journal: Anesthesiology Date: 2016-04 Impact factor: 7.892
Authors: Giorgia Carra; Marine Flechet; An Jacobs; Sören Verstraete; Dirk Vlasselaers; Lars Desmet; Hanna Van Cleemput; Pieter Wouters; Ilse Vanhorebeek; Greet Van den Berghe; Fabian Güiza; Geert Meyfroidt Journal: Crit Care Med Date: 2021-06-01 Impact factor: 9.296