Abstract 162: Noninvasive Measurement of Cerebral Blood Flow in Piglets During Resuscitation Induced Physiologic Challenges
Introduction: Monitoring brain blood flow and oxygenation is essential during treatment of patients in which brain perfusion may be compromised, and may serve as a future goal to direct therapy. However, there are currently no noninvasive devices that measure cerebral blood flow (CBF) and oxygenation continuously. The Cerox monitor (Ornim Medical, Lod, Israel) is a novel device, based on Near Infra Red Spectroscopy, that enables rapid, noninvasive measurement of these parameters. The aim of this study is to examine the ability of the Cerox to monitor CBF during different resuscitative maneuvers.
Methods: Four piglets were anesthesized and ventilated. CBF was manipulated by iv Norepinephrine (2.5μg/Kg), Hypercapnea (FiCO2=7%), Hyperventilation (ETCO2=25mmHg) and iv Acetazolamide (12.5mg/Kg). CBF was monitored using the Cerox (CBFcer) and a Laser Doppler Electrode (Moore Instruments, UK) (CBFld). Results are reported as percent±SE.
Results: Epinehrine injection: Average heart rate was 200±44% CBFcer was 350±125%, and CBFld was 175±28%. Cerox detected 7/8 cases of CBF rise. Hypercapnea: Average ETCO2 was 65±3 mmHg, CBFcer was 172±23%, and CBFld was 163±18%. Cerox detected 8/8 cases of CBF rise. Hyperventilation: Average ETCO2 was 26±0.7mmHg, CBFcer was 74±5.5%, and CBFld was 74±7.5%. Cerox detected 4/5 cases of CBF decrease. Acetazolamide: Average ETCO2 was 23±2.7mmHg, CBFcer was 80±2.1%, and CBFld was 78±6.2%. Cerox detected 4/4 cases of CBF decrease. Total agreement between CBFcer and CBFld was 23/25 cases (92%), with a Kappa=0.828.
Conclusions: In clinical scenarios such as resuscitation, where cerebral perfusion may be compromized, continuous noninvasive monitoring of CBF is feasible during treatment, may provide crucial information to caregivers, alter treatment and change neurological outcome.
- © 2010 by American Heart Association, Inc.