• Hironobu Hayashi, Masahiro Okamoto, Hideaki Kawanishi, Nobuoki Tabayashi, Toyoaki Matsuura, Shigeki Taniguchi, and Masahiko Kawaguchi.
• Department of Anesthesiology, Nara Medical University, Nara, Japan. Electronic address: payashi77@hotmail.com.
• J. Cardiothorac. Vasc. Anesth. 2018 Apr 1; 32 (2): 702-708.

ObjectiveThis study was designed to investigate the association between ocular blood flow measured using laser speckle flowgraphy (LSFG) and radial arterial pressure during aortic arch surgery.DesignA prospective study.SettingA single university hospital.ParticipantsThis study included 24 patients undergoing aortic arch surgery with cardiopulmonary bypass (CPB) using antegrade selective cerebral perfusion (SCP).InterventionsMeasurement of optic nerve head blood flow using LSFG and radial arterial pressure via a catheter in the radial artery METHODS AND MAIN RESULTS: Antegrade SCP was managed with 24℃ and 40-to-60 mmHg at the right radial artery, which usually corresponds to a flow rate of 10 mL/kg/min. Optic nerve head blood flow using LSFG and radial arterial blood pressure were evaluated simultaneously at the right side and recorded at the following 4 points: after the induction of anesthesia (phase 1), after the beginning of CPB (phase 2), after the beginning of antegrade SCP (phase 3), and after cessation of CPB (phase 4). A moderate positive correlation between %change of mean blur rate in the optic nerve head measured using LSFG and %change of radial mean arterial pressure was identified (r = 0.604, p < 0.001). Bland-Altman analysis showed that the bias (mean difference) was -1.2% (95% limits of agreement -47.4% to 45.0%), indicating good agreement between %changes of the values recorded using the 2 measurements.ConclusionsIntraoperative monitoring of optic nerve head blood flow using LSFG can be used as an additional cerebral perfusion parameter during aortic arch surgery with CPB using antegrade SCP.Copyright © 2017 Elsevier Inc. All rights reserved.

33 keywords...

hide…