• The Korean Journal of Pain
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• 제23권2호
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• pp.142-146
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• 2010

Background: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation ($rSO_2$). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. Methods: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. Results: The increments of the $rSO_2$ on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The $rSO_2$ on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. Conclusions: We observed an increment of the $rSO_2$ on the block side from the baseline; however, the $rSO_2$ on the non-block side decreased.

• Neonatal Medicine
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• 제28권1호
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• pp.14-21
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• 2021

Purpose: Premature infants have immature respiratory control and cerebral autoregulation. We aimed to investigate changes in cerebral oxygenation during apnea with and without peripheral oxygen desaturation in premature infants. Methods: This prospective observational study was conducted at Inha University Hospital. Near-infrared spectroscopy (NIRS)-monitored regional cerebral oxygen saturation (rScO₂) and pulse oximeter-monitored peripheral oxygen saturation (SpO₂) were assessed during the first week of life in 16 stable, spontaneously breathing preterm infants. Apneic episodes that lasted for ≥20 seconds or were accompanied by desaturation or bradycardia were included for analysis. The average rScO₂ value during the 5-minute prior to apnea (baseline), the lowest rScO₂ value following apnea (nadir), the time to recover to baseline (recovery time), the area under the curve (AUC), and the overshoot above the baseline after recovery were analyzed. Results: The median gestational age and birth weight of the infants were 29.2 weeks (interquartile range [IQR], 28.5 to 30.5) and 1,130 g (IQR, 985 to 1,245), respectively. A total of 73 apneic episodes were recorded at a median postnatal age of 2 days (IQR, 1 to 4). The rScO₂ decreased significantly following apneic episodes regardless accompanied desaturation. There were no differences in baseline, nadir, or overshoot rScO₂ between the two groups. However, the rScO₂ AUC for apnea with desaturation was significantly higher than that for apnea without desaturation. Conclusion: Cerebral oxygenation can significantly decrease during apnea, especially when accompanied by reduced SpO₂. These results add the evidence for the clinical utility of NIRS in monitoring premature infants.

• Journal of Chest Surgery
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• 제47권2호
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• pp.163-166
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• 2014

A 49-year-old man with drowsy mentality was diagnosed with acute type A aortic dissection; he underwent an emergency operation. When selective antegrade cerebral perfusion was initiated, the right regional cerebral oxygen saturation ($rSO_2$) decreased as compared to the left one. Adequate blood flow was perfused through the branch of the artificial graft, after distal anastomosis, but the right $rSO_2$ did not recover. Angiography revealed another intimal tear on the right common carotid artery. A stent was then inserted. The right $rSO_2$ promptly increased to the same level as that of the left one. The patient was discharged without any neurologic complications.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.103-106
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• 2018

Fat embolism refers to the presence of fat droplets within the peripheral and lung microcirculation with or without clinical sequelae. However, early diagnosis of fat embolism is very difficult because the embolism usually does not show at the computed tomography as a large fat complex within vessels. Forty-eight-year-old male with pedestrian traffic accident ransferred from a local hospital by helicopter to the regional trauma center by two flight surgeons on board. At the rendezvous point, he had suffered with dyspnea without any airway obstruction sign with 90% of oxygen saturation from pulse oximetry with giving 15 L of oxygen by a reserve bag mask. The patient was intubated at the rendezvous point. The secondary survey of the patient revealed multiple pelvic bone fracture with sacrum fracture, right femur shaft fracture and right tibia head fracture. Abdominal computed tomography was performed in 191 minutes after the injury and fat embolism with Hounsfield unit of -86 in his right common iliac vein was identified. Here is a very rare case that mass of fat embolism was shown within common iliac vein detected in computed tomography. Early detection of the fat embolus and early stabilization of the fractures are essential to the prevention of sequelae such as cerebral fat embolism.