Cannula malposition during antegrade cerebral perfusion for aortic surgery: Role of cerebral oximetry
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摘要Purpose: To describe the use of cerebral oximetry to detect a lack of right cerebral perfusion resulting from a malpositioned catheter used for antegrade cerebral perfusion during deep hypothermic circulatory arrest (DHCA). The simple corrective surgical adjustment that followed averted a potentially serious complication. Clinical features: A 57-yr-old male with a type-A aortic dissection undergoing DHCA required antegrade cerebral perfusion for cerebral protection. Catheters were placed accordingly in the left common carotid and brachiocephalic arteries. Whereas frontal cerebral oximetry immediately improved on the left, it did not improve on the right. It was immediately suspected that the tip of the brachiocephalic cannula had advanced into the right subclavian artery, thus depriving the right common carotid artery of blood flow. The problem resolved upon slight withdrawal of the cannula. Conclusion: Vigilance in anesthesia should not stop during DHCA or cardiopulmonary bypass. Cerebral oximetry may provide important information leading to actions that improve brain protection. Vigilances proved important in this case where the cannula tip used for antegrade cerebral perfusion was advanced too far into the right subclavian artery. © 2014 Canadian Anesthesiologists' Society.
著者Chan S.K.C., Underwood M.J., Ho A.M.-H., So J.M., Ho A.K., Wan I.Y.P., Wong R.H.L.
期刊名稱Canadian Journal of Anesthesia / Journal canadien d'anesthésie
出版年份2014
月份1
日期1
卷號61
期次8
出版社Canadian Anesthesiolgists' Society/Societe Canadienne des Anesthesistes
出版地Canada
頁次736 - 740
國際標準期刊號0832-610X
電子國際標準期刊號1496-8975
語言英式英語

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