A mesenteric traction syndrome affects near-infrared spectroscopy evaluated cerebral oxygenation because skin blood flow increases

During abdominal surgery manipulation of internal organs may induce a “mesenteric traction syndrome” (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (S...

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Veröffentlicht in:Journal of clinical monitoring and computing 2018-04, Vol.32 (2), p.261-268
Hauptverfasser: Olesen, Niels D., Sørensen, Henrik, Ambrus, Rikard, Svendsen, Lars B., Lund, Anton, Secher, Niels H.
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Sprache:eng
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Zusammenfassung:During abdominal surgery manipulation of internal organs may induce a “mesenteric traction syndrome” (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (S c O 2 ) by an increase in forehead skin blood flow (SkBF). The study intended to include 10 patients who developed MTS during pancreaticoduodenectomy and 22 patients were enrolled (age 61 ± 8 years; mean ± SD). NIRS determined ScO 2 , laser Doppler flowmetry determined SkBF, cardiac output (CO) was evaluated by pulse-contour analysis (Modelflow), and transcranial Doppler assessed middle cerebral artery mean flow velocity (MCA V mean ). MTS was identified by flushing within 60 min after start of surgery. MTS developed 20 min (12–24; median with range) after the start of surgery and heart rate (78 ± 16 vs. 68 ± 17 bpm; P  = 0.0032), CO (6.2 ± 1.4 vs. 5.3 ± 1.1 L min −1 ; P  = 0.0086), SkBF (98 ± 35 vs. 80 ± 23 PU; P  = 0.0271), and S c O 2 (71 ± 6 vs. 67 ± 8%; P  
ISSN:1387-1307
1573-2614
DOI:10.1007/s10877-017-0014-2