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Erschienen in:
01.10.2009 | Original Article
Near-Infrared Spectroscopy for Evaluation of Cerebral Autoregulation During Orthotopic Liver Transplantation
Erschienen in: Neurocritical Care | Ausgabe 2/2009
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Introduction
The present study evaluated whether frontal lobe cerebral oxygenation (ScO2), as assessed by near-infrared spectroscopy (NIRS), can detect cerebral autoregulation in patients undergoing orthotopic liver transplantation.
Methods
We studied changes in frontal lobe ScO2 assessed in 33 patients, 19 females, who underwent orthotopic liver transplantation (OLT). We evaluated whether ScO2 would remain stable over a wide range of MAP and whether an eventual drop in ScO2 could be related to a low MAP.
Results
Among the 31 of 33 patients for whom a NIRS signal could be detected, ScO2 varied in parallel with mean arterial pressure (MAP) for 3 patients and, therefore, an autoregulation curve could not be established and yet, there was detected no change in ScO2 to a lowest MAP ranging from 42 to 66 mmHg for 20 patients, while for 8 patients a decrease in ScO2 was detected at a MAP of 69 (50–90) mmHg; (median and range). As detected by NIRS, the present study confirms that some patients undergoing liver transplantation do not demonstrate cerebral autoregulation but for the majority of the patients, ScO2 was stable over a wide range of MAP suggesting that ScO2 detects cerebral autoregulation.
Conclusion
We find that NIRS is a ready available non-invasive technology for evaluation of cerebral autoregulation in patients undergoing orthotopic liver transplantation.