Результаты исследований: Научные публикации в периодических изданиях › статья › Рецензирование
The role of stump pressure and cerebral oximetry in predicting ischaemic brain damage during carotid endarterectomy. / Kuzhuget, Rossi; Starodubtsev, Vladimir; Ignatenko, Pavel и др.
в: Brain Injury, Том 31, № 13-14, 06.12.2017, стр. 1944-1950.Результаты исследований: Научные публикации в периодических изданиях › статья › Рецензирование
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TY - JOUR
T1 - The role of stump pressure and cerebral oximetry in predicting ischaemic brain damage during carotid endarterectomy
AU - Kuzhuget, Rossi
AU - Starodubtsev, Vladimir
AU - Ignatenko, Pavel
AU - Starodubtseva, Alexandra
AU - Voroshilina, Olga
AU - Ruzankin, Pavel
AU - Karpenko, Andrey
PY - 2017/12/6
Y1 - 2017/12/6
N2 - Objective is to compare the predictive value of stump pressure (SP) and cerebral oximetry (rSO2) levels in the evaluation of ischaemic injury of the cerebrum during clamping of the carotid artery (CCA) without temporary shunt (TS). Methods We included 84 patients with an asymptomatic stenosis (>70%) of the internal carotid artery (ICA) who underwent carotid endarterectomy (CEA) under GA. Cerebral ischaemic tolerance (CIT) was determined on the basis of SP, rSO2 and ∆rSO2 (↓rSO2 from baseline) during CCA. The levels of S100 protein (S100) and neuron-specific enolase (NSE) were measured on each stage of the study. MRI was performed for all patients. Results There were no perioperative strokes and myocardial infarctions during the study. Temporary shutdown of blood flow in CAs during CEA is accompanied by a significant elevation of S100, NSE concentration with their subsequent restoration (three days after surgery). ROC analysis showed that none of the methods for CIT assessment (SP, rSO2 and ∆rSO2) was a valuable predictor of cerebral damage during CEA. Conclusion SP with a threshold value of ≤40 mmHg has an average quality of prediction (AUC = 63). ∆rSO2 of ≥20% and a threshold value of rSO2 ≤ 40% have an unsatisfactory quality of prediction (AUC < 60).
AB - Objective is to compare the predictive value of stump pressure (SP) and cerebral oximetry (rSO2) levels in the evaluation of ischaemic injury of the cerebrum during clamping of the carotid artery (CCA) without temporary shunt (TS). Methods We included 84 patients with an asymptomatic stenosis (>70%) of the internal carotid artery (ICA) who underwent carotid endarterectomy (CEA) under GA. Cerebral ischaemic tolerance (CIT) was determined on the basis of SP, rSO2 and ∆rSO2 (↓rSO2 from baseline) during CCA. The levels of S100 protein (S100) and neuron-specific enolase (NSE) were measured on each stage of the study. MRI was performed for all patients. Results There were no perioperative strokes and myocardial infarctions during the study. Temporary shutdown of blood flow in CAs during CEA is accompanied by a significant elevation of S100, NSE concentration with their subsequent restoration (three days after surgery). ROC analysis showed that none of the methods for CIT assessment (SP, rSO2 and ∆rSO2) was a valuable predictor of cerebral damage during CEA. Conclusion SP with a threshold value of ≤40 mmHg has an average quality of prediction (AUC = 63). ∆rSO2 of ≥20% and a threshold value of rSO2 ≤ 40% have an unsatisfactory quality of prediction (AUC < 60).
KW - Carotid endarterectomy
KW - cerebral circulation
KW - cerebral damage markers
KW - cerebral ischaemia
KW - BIOMARKERS
KW - STROKE
KW - PROTEIN
KW - NEURON-SPECIFIC ENOLASE
KW - TRANSCRANIAL DOPPLER
KW - GENERAL-ANESTHESIA
UR - http://www.scopus.com/inward/record.url?scp=85029447197&partnerID=8YFLogxK
U2 - 10.1080/02699052.2017.1347279
DO - 10.1080/02699052.2017.1347279
M3 - Article
C2 - 28872355
AN - SCOPUS:85029447197
VL - 31
SP - 1944
EP - 1950
JO - Brain Injury
JF - Brain Injury
SN - 0269-9052
IS - 13-14
ER -
ID: 9429177