L’oxymétrie cérébrale transcutanée en anesthésie pédiatrique |
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Authors: | O Raux C SolaC Macq C Dadure |
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Institution: | Service d’anesthésie et réanimation Lapeyronie, CHU Lapeyronie, 375, avenue du Doyen Gaston-Giraud, 34295 Montpellier cedex, France |
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Abstract: | Cerebral oximetry allows continuous real-time and non-invasive monitoring of cerebral oxygen saturation (cSO2), by measuring oxyhaemoglobin and deoxyhaemoglobin near infrared light absorption, similarly to pulse oximetry. cSO2 measurement predominantly reflects brain venous compartment, and is correlated with jugular venous saturation. As jugular venous saturation, cSO2 must therefore be interpreted as a measure of balance between transport and consumption of O2 in the brain. Cerebral oximetry should be used as a trend monitoring, because its accuracy is insufficient to be considered as reliable measure of absolute value of ScO2. In adult, correction of intraoperative cerebral desaturation reduces hospital stay, heavy morbidity and mortality, and serious postoperative neurocognitive impairment after cardiac and major abdominal surgery. In children, the occurrence of intra- and postoperative cerebral desaturations during congenital heart surgery is associated with increased neurological morbi-mortality. Cerebral oximetry could be a useful monitoring during anaesthesia of (ex) preterm neonates, due to the risk of impaired cerebral blood flow autoregulation in these patients. |
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Keywords: | Monitorage non invasif Spectroscopie de proche infrarouge Oxymé trie cé ré brale Enfant Nouveau-né Pré maturé |
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