Intraoperative Vascular Neuromonitoring in Patients with Subarachnoid Hemorrhage: A Pilot Study Using Combined Laser-Doppler Spectrophotometry

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Details zur Publikation

Autor(en): Schmitz E, Bischoff B, Wolf D, Schmitt H, Eyupoglu IY, Roessler K, Buchfelder M, Sommer B
Zeitschrift: World Neurosurgery
Jahr der Veröffentlichung: 2017
Band: 107
Seitenbereich: 542-548
ISSN: 1878-8750


Abstract

BACKGROUND: Intraoperative monitoring of cerebral microcirculation in patients with subarachnoid hemorrhage (SAH) may predict the postoperative neurologic outcome. In this pilot study, we examined the value of a novel noninvasive real-time measurement technique for detecting changes in local microcirculation.
METHODS: We used the O2C (Oxygen to see) laser-Doppler spectrophotometry system in 14 patients with Hunt & Hess grade 2-5 SAH who underwent microsurgical cerebral aneurysm clipping. A subdural probe recorded capillary venous oxygenation (SO2), relative hemoglobin concentration, blood cell velocity, and blood flow at a tissue depth of 7 mm. Data were recorded immediately before dural closure. We also recorded somatosensory evoked potentials (SEPs) with median and tibial nerve stimulation. Results were compared with neurologic performance, as measured on the modified Rankin Scale, at the day of discharge from the hospital and 12 months thereafter.
RESULTS: Patient functional outcomes after discharge and 12 months were correlated with pathological decreased flow and increased SO2 values. In 6 of 8 patients, microcirculatory monitoring parameters indicated ischemia during surgery, as shown by electrophysiological SEP changes and infarction detected on the postoperative computed tomography (CT) scan. Pathological SEP results correlated closely with infarct demarcation as seen on CT.
CONCLUSIONS: Our results indicate the potential benefit of intraoperative combined laser-Doppler flowmetry and spectrophotometry for predicting postoperative clinical outcomes in this small patient sample. Larger-cohort testing is needed to verify our findings and show the possible merits of this novel method.


FAU-Autoren / FAU-Herausgeber

Buchfelder, Michael Prof. Dr.
Lehrstuhl für Neurochirurgie
Schmitt, Hubert apl. Prof. Dr.
Medizinische Fakultät
Schmitz, Emilija
Lehrstuhl für Neurochirurgie


Zusätzliche Organisationseinheit(en)
Anästhesiologische Klinik


Autor(en) der externen Einrichtung(en)
Universitäts-Herzzentrum Freiburg - Bad Krozingen GmbH


Zitierweisen

APA:
Schmitz, E., Bischoff, B., Wolf, D., Schmitt, H., Eyupoglu, I.Y., Roessler, K.,... Sommer, B. (2017). Intraoperative Vascular Neuromonitoring in Patients with Subarachnoid Hemorrhage: A Pilot Study Using Combined Laser-Doppler Spectrophotometry. World Neurosurgery, 107, 542-548. https://dx.doi.org/10.1016/j.wneu.2017.08.011

MLA:
Schmitz, Emilija, et al. "Intraoperative Vascular Neuromonitoring in Patients with Subarachnoid Hemorrhage: A Pilot Study Using Combined Laser-Doppler Spectrophotometry." World Neurosurgery 107 (2017): 542-548.

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Zuletzt aktualisiert 2019-09-01 um 09:38

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