Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors
Purpose The ability to assess the brain-at-risk during carotid endarterectomy (CEA) under general anesthesia remains a major clinical problem. Point-of-care monitoring can potentially dictate changes to management intraoperatively. In this observational study, we examined the correlation between a s...
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| Veröffentlicht in: | Canadian journal of anesthesia 2010-10, Vol.57 (10), p.903-912 |
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| creator | Espenell, Ainsley E. G. McIntyre, Ian W. Gulati, Harleena Girling, Linda G. Wilkinson, Marshall F. Silvaggio, Joseph A. Koulack, Joshua West, Michael Harding, Gregory E. J. Kaufmann, Anthony M. Mutch, W. Alan C. |
| description | Purpose
The ability to assess the brain-at-risk during carotid endarterectomy (CEA) under general anesthesia remains a major clinical problem. Point-of-care monitoring can potentially dictate changes to management intraoperatively. In this observational study, we examined the correlation between a series of point-of-care monitors and lactate flux during CEA.
Methods
Both neurosurgeons and vascular surgeons participated in the study. The patients underwent arterial-jugular venous blood sampling for oxygen, carbon dioxide, glucose, and lactate,
n
= 26; bispectral index (BIS) monitoring ipsilateral to side of surgery,
n
= 26; raw and processed electroencephalogram (EEG),
n
= 22; and bi-frontal cerebral oximetry using the Fore-Sight monitor,
n
= 20.
Results
One patient experienced a new neurological deficit when assessed at 24 hr following surgery. Lactate flux into the brain was correlated with the greatest decrease in cerebral oximetry with carotid cross-clamping; lactate efflux was correlated with the least. The most noticeable changes in processed EEG (density spectral analysis) were also seen with lactate influx, but at a slower time resolution than cerebral oximetry. Loss of autoregulatory behaviour was demonstrated with lactate influx; however, no correlation was seen between lactate flux and BIS monitoring.
Conclusion
There was a correlation between cerebral oximetry and lactate flux during carotid cross-clamping. The Fore-Sight monitor may be of value as a point-of-care monitor during CEA under general anesthesia. A novel finding of this study is lactate flux into the brain in the presence of a large difference in cerebral oxygenation during cross-clamping of the carotid artery.
Registered at clinicaltrials.gov: NCT000737334. |
| doi_str_mv | 10.1007/s12630-010-9356-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_755191644</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>755191644</sourcerecordid><originalsourceid>FETCH-LOGICAL-c443t-2c8b9dfbee08b6164b3f35d7987ee9c4d4aa1bdc779109ada9c53261093614263</originalsourceid><addsrcrecordid>eNp1kU1rFTEUhoMo9rb6A9xIEMRVNJnM5MOdFL_gghsFdyGTnGlTZpJrkqn235vhXi0IrrJ5zpvnnBehZ4y-ZpTKN4V1glNCGSWaD4LIB2jHei2I0nJ4iHZU8Y4IRr-fofNSbiilSgzqMTrrqBBMKLpDdW9dtRXwNK-_sF9ziFfY2Zxq8Biit7lCBlfTcofX6CHjK4iQ7YxthFKvoQT7FruUM8y2hhTxz1Cv8a3NIa0FH1KIlaSJtEjAS4qhplyeoEeTnQs8Pb0X6NuH918vP5H9l4-fL9_tiet7Xknn1Kj9NAJQNTbffuQTH7zUSgJo1_veWjZ6J6VmVFtvtRt41_bVXLC-neYCvTrmHnL6sTZds4TiYJ6be7MzchiYbrl9I1_8Q96kNccmZ5TsBtrOtkHsCLmcSskwmUMOi813hlGzFWKOhZhWiNkKMbLNPD8Fr-MC_u_EnwYa8PIE2OLsPGUbXSj3HG-7CL0FdUeuHLaOIN8b_v_33-VRpM8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>872506584</pqid></control><display><type>article</type><title>Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors</title><source>MEDLINE</source><source>Springer Online Journals - JUSTICE</source><creator>Espenell, Ainsley E. G. ; McIntyre, Ian W. ; Gulati, Harleena ; Girling, Linda G. ; Wilkinson, Marshall F. ; Silvaggio, Joseph A. ; Koulack, Joshua ; West, Michael ; Harding, Gregory E. J. ; Kaufmann, Anthony M. ; Mutch, W. Alan C.</creator><creatorcontrib>Espenell, Ainsley E. G. ; McIntyre, Ian W. ; Gulati, Harleena ; Girling, Linda G. ; Wilkinson, Marshall F. ; Silvaggio, Joseph A. ; Koulack, Joshua ; West, Michael ; Harding, Gregory E. J. ; Kaufmann, Anthony M. ; Mutch, W. Alan C.</creatorcontrib><description>Purpose
The ability to assess the brain-at-risk during carotid endarterectomy (CEA) under general anesthesia remains a major clinical problem. Point-of-care monitoring can potentially dictate changes to management intraoperatively. In this observational study, we examined the correlation between a series of point-of-care monitors and lactate flux during CEA.
Methods
Both neurosurgeons and vascular surgeons participated in the study. The patients underwent arterial-jugular venous blood sampling for oxygen, carbon dioxide, glucose, and lactate,
n
= 26; bispectral index (BIS) monitoring ipsilateral to side of surgery,
n
= 26; raw and processed electroencephalogram (EEG),
n
= 22; and bi-frontal cerebral oximetry using the Fore-Sight monitor,
n
= 20.
Results
One patient experienced a new neurological deficit when assessed at 24 hr following surgery. Lactate flux into the brain was correlated with the greatest decrease in cerebral oximetry with carotid cross-clamping; lactate efflux was correlated with the least. The most noticeable changes in processed EEG (density spectral analysis) were also seen with lactate influx, but at a slower time resolution than cerebral oximetry. Loss of autoregulatory behaviour was demonstrated with lactate influx; however, no correlation was seen between lactate flux and BIS monitoring.
Conclusion
There was a correlation between cerebral oximetry and lactate flux during carotid cross-clamping. The Fore-Sight monitor may be of value as a point-of-care monitor during CEA under general anesthesia. A novel finding of this study is lactate flux into the brain in the presence of a large difference in cerebral oxygenation during cross-clamping of the carotid artery.
Registered at clinicaltrials.gov: NCT000737334.</description><identifier>ISSN: 0832-610X</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/s12630-010-9356-7</identifier><identifier>PMID: 20661680</identifier><identifier>CODEN: CJOAEP</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Aged ; Anesthesia ; Anesthesia, General - adverse effects ; Anesthesia, General - methods ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesiology ; Biological and medical sciences ; Brain - metabolism ; Cardiology ; Carotid arteries ; Cohort Studies ; Consciousness Monitors ; Critical Care Medicine ; Dysarthria ; Electroencephalography ; Electroencephalography - methods ; Endarterectomy, Carotid - adverse effects ; Endarterectomy, Carotid - methods ; Female ; General anesthesia ; Glucose ; Humans ; Intensive ; Ischemia ; Lactic Acid - blood ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Intraoperative - instrumentation ; Monitoring, Intraoperative - methods ; Oximetry - methods ; Oxygen - blood ; Pain Medicine ; Patients ; Pediatrics ; Pneumology/Respiratory System ; Point-of-Care Systems ; Postoperative Complications - etiology ; Postoperative Complications - prevention & control ; Prospective Studies ; Regional anesthesia ; Reports of Original Investigations ; Surgery</subject><ispartof>Canadian journal of anesthesia, 2010-10, Vol.57 (10), p.903-912</ispartof><rights>Canadian Anesthesiologists' Society 2010</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c443t-2c8b9dfbee08b6164b3f35d7987ee9c4d4aa1bdc779109ada9c53261093614263</citedby><cites>FETCH-LOGICAL-c443t-2c8b9dfbee08b6164b3f35d7987ee9c4d4aa1bdc779109ada9c53261093614263</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12630-010-9356-7$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12630-010-9356-7$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23361697$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20661680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Espenell, Ainsley E. G.</creatorcontrib><creatorcontrib>McIntyre, Ian W.</creatorcontrib><creatorcontrib>Gulati, Harleena</creatorcontrib><creatorcontrib>Girling, Linda G.</creatorcontrib><creatorcontrib>Wilkinson, Marshall F.</creatorcontrib><creatorcontrib>Silvaggio, Joseph A.</creatorcontrib><creatorcontrib>Koulack, Joshua</creatorcontrib><creatorcontrib>West, Michael</creatorcontrib><creatorcontrib>Harding, Gregory E. J.</creatorcontrib><creatorcontrib>Kaufmann, Anthony M.</creatorcontrib><creatorcontrib>Mutch, W. Alan C.</creatorcontrib><title>Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anesth/J Can Anesth</addtitle><addtitle>Can J Anaesth</addtitle><description>Purpose
The ability to assess the brain-at-risk during carotid endarterectomy (CEA) under general anesthesia remains a major clinical problem. Point-of-care monitoring can potentially dictate changes to management intraoperatively. In this observational study, we examined the correlation between a series of point-of-care monitors and lactate flux during CEA.
Methods
Both neurosurgeons and vascular surgeons participated in the study. The patients underwent arterial-jugular venous blood sampling for oxygen, carbon dioxide, glucose, and lactate,
n
= 26; bispectral index (BIS) monitoring ipsilateral to side of surgery,
n
= 26; raw and processed electroencephalogram (EEG),
n
= 22; and bi-frontal cerebral oximetry using the Fore-Sight monitor,
n
= 20.
Results
One patient experienced a new neurological deficit when assessed at 24 hr following surgery. Lactate flux into the brain was correlated with the greatest decrease in cerebral oximetry with carotid cross-clamping; lactate efflux was correlated with the least. The most noticeable changes in processed EEG (density spectral analysis) were also seen with lactate influx, but at a slower time resolution than cerebral oximetry. Loss of autoregulatory behaviour was demonstrated with lactate influx; however, no correlation was seen between lactate flux and BIS monitoring.
Conclusion
There was a correlation between cerebral oximetry and lactate flux during carotid cross-clamping. The Fore-Sight monitor may be of value as a point-of-care monitor during CEA under general anesthesia. A novel finding of this study is lactate flux into the brain in the presence of a large difference in cerebral oxygenation during cross-clamping of the carotid artery.
Registered at clinicaltrials.gov: NCT000737334.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia, General - adverse effects</subject><subject>Anesthesia, General - methods</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesiology</subject><subject>Biological and medical sciences</subject><subject>Brain - metabolism</subject><subject>Cardiology</subject><subject>Carotid arteries</subject><subject>Cohort Studies</subject><subject>Consciousness Monitors</subject><subject>Critical Care Medicine</subject><subject>Dysarthria</subject><subject>Electroencephalography</subject><subject>Electroencephalography - methods</subject><subject>Endarterectomy, Carotid - adverse effects</subject><subject>Endarterectomy, Carotid - methods</subject><subject>Female</subject><subject>General anesthesia</subject><subject>Glucose</subject><subject>Humans</subject><subject>Intensive</subject><subject>Ischemia</subject><subject>Lactic Acid - blood</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative - instrumentation</subject><subject>Monitoring, Intraoperative - methods</subject><subject>Oximetry - methods</subject><subject>Oxygen - blood</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Pneumology/Respiratory System</subject><subject>Point-of-Care Systems</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prospective Studies</subject><subject>Regional anesthesia</subject><subject>Reports of Original Investigations</subject><subject>Surgery</subject><issn>0832-610X</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1rFTEUhoMo9rb6A9xIEMRVNJnM5MOdFL_gghsFdyGTnGlTZpJrkqn235vhXi0IrrJ5zpvnnBehZ4y-ZpTKN4V1glNCGSWaD4LIB2jHei2I0nJ4iHZU8Y4IRr-fofNSbiilSgzqMTrrqBBMKLpDdW9dtRXwNK-_sF9ziFfY2Zxq8Biit7lCBlfTcofX6CHjK4iQ7YxthFKvoQT7FruUM8y2hhTxz1Cv8a3NIa0FH1KIlaSJtEjAS4qhplyeoEeTnQs8Pb0X6NuH918vP5H9l4-fL9_tiet7Xknn1Kj9NAJQNTbffuQTH7zUSgJo1_veWjZ6J6VmVFtvtRt41_bVXLC-neYCvTrmHnL6sTZds4TiYJ6be7MzchiYbrl9I1_8Q96kNccmZ5TsBtrOtkHsCLmcSskwmUMOi813hlGzFWKOhZhWiNkKMbLNPD8Fr-MC_u_EnwYa8PIE2OLsPGUbXSj3HG-7CL0FdUeuHLaOIN8b_v_33-VRpM8</recordid><startdate>20101001</startdate><enddate>20101001</enddate><creator>Espenell, Ainsley E. G.</creator><creator>McIntyre, Ian W.</creator><creator>Gulati, Harleena</creator><creator>Girling, Linda G.</creator><creator>Wilkinson, Marshall F.</creator><creator>Silvaggio, Joseph A.</creator><creator>Koulack, Joshua</creator><creator>West, Michael</creator><creator>Harding, Gregory E. J.</creator><creator>Kaufmann, Anthony M.</creator><creator>Mutch, W. Alan C.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20101001</creationdate><title>Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors</title><author>Espenell, Ainsley E. G. ; McIntyre, Ian W. ; Gulati, Harleena ; Girling, Linda G. ; Wilkinson, Marshall F. ; Silvaggio, Joseph A. ; Koulack, Joshua ; West, Michael ; Harding, Gregory E. J. ; Kaufmann, Anthony M. ; Mutch, W. Alan C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c443t-2c8b9dfbee08b6164b3f35d7987ee9c4d4aa1bdc779109ada9c53261093614263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia, General - adverse effects</topic><topic>Anesthesia, General - methods</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Anesthesiology</topic><topic>Biological and medical sciences</topic><topic>Brain - metabolism</topic><topic>Cardiology</topic><topic>Carotid arteries</topic><topic>Cohort Studies</topic><topic>Consciousness Monitors</topic><topic>Critical Care Medicine</topic><topic>Dysarthria</topic><topic>Electroencephalography</topic><topic>Electroencephalography - methods</topic><topic>Endarterectomy, Carotid - adverse effects</topic><topic>Endarterectomy, Carotid - methods</topic><topic>Female</topic><topic>General anesthesia</topic><topic>Glucose</topic><topic>Humans</topic><topic>Intensive</topic><topic>Ischemia</topic><topic>Lactic Acid - blood</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative - instrumentation</topic><topic>Monitoring, Intraoperative - methods</topic><topic>Oximetry - methods</topic><topic>Oxygen - blood</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Pneumology/Respiratory System</topic><topic>Point-of-Care Systems</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prospective Studies</topic><topic>Regional anesthesia</topic><topic>Reports of Original Investigations</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Espenell, Ainsley E. G.</creatorcontrib><creatorcontrib>McIntyre, Ian W.</creatorcontrib><creatorcontrib>Gulati, Harleena</creatorcontrib><creatorcontrib>Girling, Linda G.</creatorcontrib><creatorcontrib>Wilkinson, Marshall F.</creatorcontrib><creatorcontrib>Silvaggio, Joseph A.</creatorcontrib><creatorcontrib>Koulack, Joshua</creatorcontrib><creatorcontrib>West, Michael</creatorcontrib><creatorcontrib>Harding, Gregory E. J.</creatorcontrib><creatorcontrib>Kaufmann, Anthony M.</creatorcontrib><creatorcontrib>Mutch, W. Alan C.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Espenell, Ainsley E. G.</au><au>McIntyre, Ian W.</au><au>Gulati, Harleena</au><au>Girling, Linda G.</au><au>Wilkinson, Marshall F.</au><au>Silvaggio, Joseph A.</au><au>Koulack, Joshua</au><au>West, Michael</au><au>Harding, Gregory E. J.</au><au>Kaufmann, Anthony M.</au><au>Mutch, W. Alan C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors</atitle><jtitle>Canadian journal of anesthesia</jtitle><stitle>Can J Anesth/J Can Anesth</stitle><addtitle>Can J Anaesth</addtitle><date>2010-10-01</date><risdate>2010</risdate><volume>57</volume><issue>10</issue><spage>903</spage><epage>912</epage><pages>903-912</pages><issn>0832-610X</issn><eissn>1496-8975</eissn><coden>CJOAEP</coden><abstract>Purpose
The ability to assess the brain-at-risk during carotid endarterectomy (CEA) under general anesthesia remains a major clinical problem. Point-of-care monitoring can potentially dictate changes to management intraoperatively. In this observational study, we examined the correlation between a series of point-of-care monitors and lactate flux during CEA.
Methods
Both neurosurgeons and vascular surgeons participated in the study. The patients underwent arterial-jugular venous blood sampling for oxygen, carbon dioxide, glucose, and lactate,
n
= 26; bispectral index (BIS) monitoring ipsilateral to side of surgery,
n
= 26; raw and processed electroencephalogram (EEG),
n
= 22; and bi-frontal cerebral oximetry using the Fore-Sight monitor,
n
= 20.
Results
One patient experienced a new neurological deficit when assessed at 24 hr following surgery. Lactate flux into the brain was correlated with the greatest decrease in cerebral oximetry with carotid cross-clamping; lactate efflux was correlated with the least. The most noticeable changes in processed EEG (density spectral analysis) were also seen with lactate influx, but at a slower time resolution than cerebral oximetry. Loss of autoregulatory behaviour was demonstrated with lactate influx; however, no correlation was seen between lactate flux and BIS monitoring.
Conclusion
There was a correlation between cerebral oximetry and lactate flux during carotid cross-clamping. The Fore-Sight monitor may be of value as a point-of-care monitor during CEA under general anesthesia. A novel finding of this study is lactate flux into the brain in the presence of a large difference in cerebral oxygenation during cross-clamping of the carotid artery.
Registered at clinicaltrials.gov: NCT000737334.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20661680</pmid><doi>10.1007/s12630-010-9356-7</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Canadian journal of anesthesia, 2010-10, Vol.57 (10), p.903-912 |
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| language | eng |
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| source | MEDLINE; Springer Online Journals - JUSTICE |
| subjects | Aged Anesthesia Anesthesia, General - adverse effects Anesthesia, General - methods Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesiology Biological and medical sciences Brain - metabolism Cardiology Carotid arteries Cohort Studies Consciousness Monitors Critical Care Medicine Dysarthria Electroencephalography Electroencephalography - methods Endarterectomy, Carotid - adverse effects Endarterectomy, Carotid - methods Female General anesthesia Glucose Humans Intensive Ischemia Lactic Acid - blood Male Medical sciences Medicine Medicine & Public Health Middle Aged Monitoring, Intraoperative - instrumentation Monitoring, Intraoperative - methods Oximetry - methods Oxygen - blood Pain Medicine Patients Pediatrics Pneumology/Respiratory System Point-of-Care Systems Postoperative Complications - etiology Postoperative Complications - prevention & control Prospective Studies Regional anesthesia Reports of Original Investigations Surgery |
| title | Lactate flux during carotid endarterectomy under general anesthesia: correlation with various point-of-care monitors |
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