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Eur J Cardiothorac Surg 2004;25:406-408
© 2004 Elsevier Science NL

Editorial comment

Post-operative neuropsychological function unaffected by SjO₂ monitoring in DHCA

First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192 Hamamatsu, Japan

^* Tel.: +81-53-435-2276; fax: +81-53-435-2272
e-mail: tkazui@hama-med.ac.jp

The first 20% of the full text of this article appears below.

Three cerebral protection methods are currently being used in thoracic aortic repair: deep hypothermic circulatory arrest (DHCA) with or without retrograde cerebral perfusion (RCP) and antegrade selective cerebral perfusion (SCP).

Dr Griepp, of Mt Sinai Hospital, having popularized this method of protecting the brain during aortic arch repair [1], is recognized as the father of DHCA, while Mt Sinai group as a whole is credited with numerous scientific papers regarding the neuroprotective effect of DHCA. However, appropriate criteria for initiating DHCA have not been established so far and tend to vary depending on the hospital. These have included electrical silence of the electroencephalogram, SjO₂ monitoring or merely measurements of temperature at different sites (rectal, bladder, esophageal, nasopharyngeal, and tympanic). At Mt Sinai, SjO₂ monitoring has been used as a marker of initiating DHCA because of the assumption that highly saturated jugular venous blood reflected global cerebral cooling as well as the concomitant cerebral metabolic suppression before the initiation of DHCA. In this issue of the journal, Reich and associates [2] from the Department of Anesthesiology at Mt Sinai Hospital, . . . [Full Text of this Article]

Related Article

Using jugular bulb oxyhemoglobin saturation to guide onset of deep hypothermic circulatory arrest does not affect post-operative neuropsychological function

David L. Reich, Loren M. Horn, Sabera Hossain, and Suzan Uysal
Eur. J. Cardiothorac. Surg. 2004 25: 401-406. [Abstract] [Full Text] [PDF]