Year: 2015 | Month: June | Volume 2 | Issue 2

Changes in Intra-cerebral Environment in Patients Undergoing Tracheotomy: An Original Research

Kenichi Satoh Mami Chikuda Ayako Ohashi Miho Kumagai Masahito Sato
DOI:10.5958/2394-4196.2015.00009.6

Abstract:

Microvascular flap reconstruction has recently proven to be very reliable for repairing defects
in the oral and maxillofacial cavity defects. Such patients often require a tracheotomy to stay in the intensive care unit post-operatively. Although tracheotomy is usually performed after oral intubation, details of the intra-cerebral oxygenation environment during tracheotomy are unclear. Using near-infrared spectroscopy, we investigated the changes in intra-cerebral oxygenation during exchange from oral to tracheal intubation in patients undergoing tracheotomy. Materials and Methods: We evaluated eight patients with an American Society of Anesthesiologists physical Status of I or II who were scheduled to undergo tracheotomy. Changes in the intra-cerebral levels of oxyhemoglobin (oxy-Hb), deoxyhemoglobin (deoxy-Hb), total hemoglobin (total-Hb), and cytochrome oxidase (cyt) were monitored during tracheotomy. Results: Blood pressure increased rapidly during exchange from an oral to tracheal intubation tube. The maximum oxy-Hb level (3.5 ± 2.4 nmol/L)
occurred 5 min after the exchange, the maximum deoxy-Hb level (0.8 ± 1.0 nmol/L) occurred 5 min after the exchange, the maximum total-Hb level (1.8 ± 2.2 nmol/L) occurred 5 min after the exchange, and the minimum cyt level (−0.5 ± 0.2 nmol/L) occurred 7 min after the start of the operation. Conclusions: The intra-cerebral oxy-Hb and total-Hb levels increased after exchange from an oral to tracheal intubation tube during tracheotomy, and these hemodynamic changes attenuated the cerebral blood flow.



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