Intraoperative cerebral perfusion in geriatric patients

Détails

ID Serval
serval:BIB_ECF63E2CE164
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Intraoperative cerebral perfusion in geriatric patients
Titre de la conférence
Annual meeting of the Swiss Society of Anaesthesiology and Resuscitation
Auteur⸱e⸱s
Burkhart C.S., Gamberini M., Moeckli A., Smielewski P., Strebel S.P., Steiner L.A.
Adresse
Interlaken, Switzerland, October 29-31, 2009
ISBN
1424-7860
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
139
Série
Swiss Medical Weekly
Pages
2S-2S
Langue
anglais
Notes
Meeting Abstract
Résumé
Background: It is unknown whether cerebral perfusion in geriatric and younger patients under general anaesthesia differs.
Methods: We compared 2 groups of patients undergoing elective major non-cardiac surgery under standardized general anaesthesia (thiopental, sevoflurane, fentanyl, atracurium). Group 1: 18-40 yrs (n = 20), Group 2: >65 yrs (n = 37). Cerebral perfusion was investigated with transcranial Doppler and near-infrared spectroscopy (NIRS). Arterial blood pressure was monitored continuously with a Finapres device. Mx, an index allowing continuous monitoring of cerebrovascular autoregulation based on the changes in mean arterial blood pressure (MAP) and cerebral blood flow velocity was calculated. Data are shown as mean } SD.
Results: MAP (86 } 9.6 vs 79 } 10.9 mm Hg, p = 0.02), end-tidal concentration of sevoflurane (1.9 } 0.3 vs 1.6 } 0.3%, p <0.01), and the cerebral tissue oxygenation index measured by NIRS (72 } 4 vs 68 } 5%, p = 0.01), were significantly lower in Group 2. The end-tidal concentration of O2 was significantly higher in Group 2 (46 } 4 vs 48 } 4% p = 0.04). There were no significant differences between Group 1 and 2 for cerebral blood flow velocity (41 } 10 vs 43 } 18 cm/s), end tidal CO2 (4.7 } 0.3 vs 4.6 } 0.3 kPa) and cerebrovascular autoregulation (Mx 0.42 } 0.2 vs 0.48 } 0.2). In Group 1 35% and in Group 2 43% of the patients had an index of autoregulation suggesting disturbed cerebrovascular autoregulation (p = n.s.).
Conclusions: In elderly patients under general anaesthesia with sevoflurane the cerebral tissue oxygenation index was significantly lower than in younger patients despite higher end-tidal oxygen concentrations. Our data suggest subtle differences in cerebral perfusion between geriatric and younger
Web of science
Création de la notice
18/11/2009 16:10
Dernière modification de la notice
20/08/2019 16:14
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