Artery Stenosis, Carotid, Hypoxia-Ischemia, Brain, Ischemia, Vertebral Artery
Conditions
Keywords
Normobaric hyperoxia, Cerebral oxygenation, Near-infrared spectroscopy, Carotid endarterectomy, TIVA
Brief summary
This study evaluates effects of high inspiratory oxygen on cerebral tissue oxygenation and patient recovery after carotid endarterectomy. Two group of patient undergoing to carotid with total intravenous anaesthesia will receive either 35% inspired oxygen or 100% oxygen.
Detailed description
High inspired oxygen concentration may reduce brain hypoxia in the patients undergoing carotid endarterectomy with total intravenous anaesthesia. However, there are some studies suggesting that high inspired oxygen concentration may induce cerebral vasoconstriction. This study was performed to measure the influence of fraction of inspired oxygen (FiO2) on the regional tissue oxygenation in the patients undergoing carotid endarterectomy with total intravenous anaesthesia. The INVOS 5100B monitor was used for regional cerebral oxygen saturation (rSO2) measurement from operative and nonoperative side, and INVOS Analytics Tool (Covidien) for area under curve (AUC) calculations. A bispectral index and invasive blood pressure monitoring were used in all patients.
Interventions
PROCEDUREOxygen concentration
Shunting, raising concentration of O2 because of improving regional cerebral oxygen saturation (rSO2), keeping blood pressure above 120-130 mmHg, positive end expiratory pressure (PEEP)
Sponsors
Osijek University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patient undergoing surgery (carotid endarterectomy)
Exclusion criteria
* decompensated and uncontrolled respiratory and cardiac disease, myocardial infarction suffered in the last 6 months, cerebrovascular infarction, coagulopathy, anaphylaxis to drugs
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Area under curve of regional cerebral oxygen saturation (rSO2) curve | During surgery | Intraoperative high oxygen concentrations may reduce intensity of tissue hypoxic episodes during carotid endarterectomy in total intravenous anesthesia (TIVA). The INVOS 5100B monitor was used for regional cerebral oxygen saturation (rSO2) measurement from operative and nonoperative side, and INVOS Analytics Tool (Covidien) for Area under curve (AUC) calculations. Data were analyzed using two sided T-test and Fisher exact test. A P\<0.05 was considered as statistically significant Postoperative follow up in large patient's group is necessary to confirm its impact on patients' outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Early neurologic recovery, TIA or brain ischemia | Till 7 days after surgery | Postoperative patient follow up by clinical signs or CT scan confirmation |
| Intensive Care Unit admission, Death | Till 7 days after surgery | — |
Countries
Croatia
Outcome results
None listed