Journal of clinical monitoring and computing
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J Clin Monit Comput · Jul 2002
Subcutaneous microdialysis for metabolic monitoring in abdominal aortic surgery.
Microdialysis, that is the sampling of interstitial fluid via semi-permeable tubes, has been shown to be suitable for detecting ischemic changes e.g. in brain and heart tissue. The purpose of the present study was to investigate the possibility of monitoring with subcutaneous microdialysis peri-operative metabolic sequelac of elective abdominal aortic surgery. In 22 patients microdialysis catheters were inserted subcutaneously in the lower leg as well as the shoulder serving as a reference topographic region. Lactate, pyruvate and glycerol, which indicate ischemia or reperfusion, were measured. We observed severe metabolic changes within the interstitial fluid of the lower extremity during ischemia followed by normalization during reperfusion. Despite high interstitial concentrations of lactate and glycerol indicating severe ischemia during clamping of the abdominal aorta these parameters returned to pre-operative values within 2 hrs after declamping and all patients recovered completely. ⋯ Subcutaneous microdialysis was able to detect metabolic changes due to ischemia during clamping of the abdominal aorta as well as reperfusion there after. It is a suitable technique to monitor the peri-operative course of the dependent tissue after abdominal aortic vascular surgery.
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J Clin Monit Comput · Jul 2002
Case ReportsMonitoring of motor evoked potentials with high intensity repetitive transcranial electrical stimulation during spinal surgery.
Clinical utility of high voltage repetitive transcranial electrical stimulation (TES) was investigated in 46 patients undergoing spine surgery. ⋯ The findings suggest that intraoperative MEP monitoring is feasible method, however, its immediate prognostic value for adequacy of neuronal decompression and improvement requires further studies with larger patient population.