The effects of different ventilator modes on cerebral tissue oxygen saturation in patients with bidirectional superior cavopulmonary connection.
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Date
2014-01
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Abstract
Aims and Objectives: We used near‑infrared spectroscopy to document changes in cerebral tissue
oxygen saturation (SctO2) in response to ventilation mode alterations after bidirectional Glenn (BDG;
superior cavopulmonary connection) procedure. We also determined whether spontaneous ventilation
have a beneficial effect on hemodynamic status, lactate and SctO2 when compared with other ventilation
modes. Materials and Methods: 20 consecutive patients undergoing BDG were included. We measured
SctO2 during three ventilator modes (intermittent positive‑pressure ventilation [IPPV]; synchronized
intermittent mandatory ventilation [SIMV]; and continuous positive airway pressure + pressure support
ventilation [CPAP + PSV]). We, also, measured mean airway pressure (AWP), arterial blood gases, lactate
and systolic arterial pressures (SAP). Results: There was no change in SctO2 in IPPV and SIMV modes;
the SctO2 measured during CPAP + PSV and after extubation increased significantly (60.5 ± 11, 61 ± 10,
65 ± 10, 66 ± 11 respectively) (P < 0.05). The differences in the SAP measured during IPPV and SIMV
modes was insignificant; the SAP increased significantly during CPAP + PSV mode and after extubation
compared with IPPV and SIMV (109 ± 11, 110 ± 12, 95 ± 17, 99 ± 13 mmHg, respectively) (P < 0.05). Mean
AWP did not change during IPPV and SIMV modes, mean AWP decreased significantly during CPAP + PSV
mode (14 ± 4, 14 ± 3, 10 ± 1 mmHg, respectively) (P < 0.01). Conclusions: The SctO2 was higher during
CPAP + PSV ventilation and after extubation compared to IPPV and SIMV modes of ventilation. The mean
AWP was lower during CPAP + PSV ventilation compared to IPPV and SIMV modes of ventilation.
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Keywords
Bidirectional Glenn procedure, Continuous positive airway pressure, Pressure support ventilation, Intermittent positive‑pressure ventilation, Synchronized intermittent mandatory ventilation
Citation
Türköz Ayda, Balcı Şule Turgut, Gönen Hülya, Çınar Özlem, Özker Emre, Türköz Rıza. The effects of different ventilator modes on cerebral tissue oxygen saturation in patients with bidirectional superior cavopulmonary connection. Annals of Cardiac Anaesthesia. 2014 Jan; 17(1): 10-15.