Reduced cerebral oxygen–carbohydrate index during endotracheal intubation in vascular surgical patients

TY - JOUR

T1 - Reduced cerebral oxygen–carbohydrate index during endotracheal intubation in vascular surgical patients

AU - Fabricius-Bjerre, Andreas

AU - Overgaard, Anders

AU - Winther-Olesen, Marie

AU - Lönn, Lars

AU - Secher, Niels H

AU - Nielsen, Henning Morris Bay

N1 - © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

PY - 2015/9/1

Y1 - 2015/9/1

N2 - Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing aortic surgery, arterial to internal jugular venous (a-v) concentration differences for oxygen versus lactate and glucose were determined from before anaesthesia to when the patient left the recovery room. Intravenous anaesthesia was supplemented with thoracic epidural anaesthesia for open aortic surgery (n = 5) and infiltration with bupivacaine for endovascular procedures (n = 14). The a-v difference for O2 decreased throughout anaesthesia and in the recovery room (1·6 ± 1·9 versus 3·2 ± 0·8 mmol l-1, mean ± SD), and while a-v glucose decreased during surgery and into the recovery (0·4 ± 0·2 versus 0·7 ± 0·2 mmol l-1, P<0·05), a-v lactate did not change significantly (0·03 ± 0·16 versus -0·03 ± 0·09 mmol l-1). Thus, OCI decreased from 5·2 ± 1·8 before induction of anaesthesia to 3·2 ± 1·0 following tracheal intubation (P<0·05) because of the decrease in a-v O2 with a recovery for OCI to 4·6 ± 1·4 during surgery and to 5·6 ± 1·7 in the recovery room. In conclusion, preparation for surgery and tracheal intubation decrease OCI that recovers during surgery under the influence of sensory blockade.

AB - Brain activation reduces balance between cerebral consumption of oxygen versus carbohydrate as expressed by the so-called cerebral oxygen-carbohydrate-index (OCI). We evaluated whether preparation for surgery, anaesthesia including tracheal intubation and surgery affect OCI. In patients undergoing aortic surgery, arterial to internal jugular venous (a-v) concentration differences for oxygen versus lactate and glucose were determined from before anaesthesia to when the patient left the recovery room. Intravenous anaesthesia was supplemented with thoracic epidural anaesthesia for open aortic surgery (n = 5) and infiltration with bupivacaine for endovascular procedures (n = 14). The a-v difference for O2 decreased throughout anaesthesia and in the recovery room (1·6 ± 1·9 versus 3·2 ± 0·8 mmol l-1, mean ± SD), and while a-v glucose decreased during surgery and into the recovery (0·4 ± 0·2 versus 0·7 ± 0·2 mmol l-1, P<0·05), a-v lactate did not change significantly (0·03 ± 0·16 versus -0·03 ± 0·09 mmol l-1). Thus, OCI decreased from 5·2 ± 1·8 before induction of anaesthesia to 3·2 ± 1·0 following tracheal intubation (P<0·05) because of the decrease in a-v O2 with a recovery for OCI to 4·6 ± 1·4 during surgery and to 5·6 ± 1·7 in the recovery room. In conclusion, preparation for surgery and tracheal intubation decrease OCI that recovers during surgery under the influence of sensory blockade.

U2 - 10.1111/cpf.12176

DO - 10.1111/cpf.12176

M3 - Journal article

C2 - 24903076

SN - 1475-0961

VL - 35

SP - 404

EP - 410

JO - Clinical Physiology and Functional Imaging

JF - Clinical Physiology and Functional Imaging

IS - 5

ER -