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Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension

Vasopressor agents may affect cerebral oxygenation (rScO(2)) as determined by near-infrared spectroscopy on the forehead. This case series evaluated the effect of calcium chloride vs. α and β-adrenergic receptor agonists on rScO(2) in patients (n = 47) undergoing surgery during i.v. anesthesia. Mean...

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Autores principales: Kitchen, Carl-Christian, Nissen, Peter, Secher, Niels H., Nielsen, Henning B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205832/
https://www.ncbi.nlm.nih.gov/pubmed/25374543
http://dx.doi.org/10.3389/fphys.2014.00407
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author Kitchen, Carl-Christian
Nissen, Peter
Secher, Niels H.
Nielsen, Henning B.
author_facet Kitchen, Carl-Christian
Nissen, Peter
Secher, Niels H.
Nielsen, Henning B.
author_sort Kitchen, Carl-Christian
collection PubMed
description Vasopressor agents may affect cerebral oxygenation (rScO(2)) as determined by near-infrared spectroscopy on the forehead. This case series evaluated the effect of calcium chloride vs. α and β-adrenergic receptor agonists on rScO(2) in patients (n = 47) undergoing surgery during i.v. anesthesia. Mean arterial pressure (MAP) and cardiac output (CO) were assessed by Model-flow(®) and ephedrine (55 ± 3 vs. 74 ± 9 mmHg; 10 mg, n = 9), phenylephrine (51 ± 5 vs. 78 ± 9 mmHg, 0.1 mg, n = 11), adrenaline (53 ± 3 vs. 72 ± 11 mmHg; 1–2 μg, n = 6), noradrenaline (53 ± 5 vs. 72 ± 12 mmHg; 2–4 μg, n = 11), and calcium chloride (49 ± 7 vs. 57 ± 16 mmHg; 5 mmol, n = 10) increased MAP (all P < 0.05). CO increased with ephedrine (4.3 ± 0.9 vs. 5.3 ± 1.2, P < 0.05) and adrenaline (4.7 ± 1.2 vs. 5.9 ± 1.1 l/min; P = 0.07) but was not significantly affected by phenylephrine (3.9 ± 0.7 vs. 3.6 ± 1.0 l/min), noradrenaline (3.8 ± 1.2 vs. 3.7 ± 0.7 l/min), or calcium chloride (4.0 ± 1.4 vs. 4.1 ± 1.5 l/min). Following administration of β-adrenergic agents and calcium chloride rScO(2) was preserved while after administration of α-adrenergic drugs rScO(2) was reduced by app. 2% (P < 0.05). Following α-adrenergic drugs to treat anesthesia-induced hypotension tissue oxygenation is reduced while the use of β-adrenergic agonists and calcium chloride preserve tissue oxygenation.
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spelling pubmed-42058322014-11-05 Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension Kitchen, Carl-Christian Nissen, Peter Secher, Niels H. Nielsen, Henning B. Front Physiol Physiology Vasopressor agents may affect cerebral oxygenation (rScO(2)) as determined by near-infrared spectroscopy on the forehead. This case series evaluated the effect of calcium chloride vs. α and β-adrenergic receptor agonists on rScO(2) in patients (n = 47) undergoing surgery during i.v. anesthesia. Mean arterial pressure (MAP) and cardiac output (CO) were assessed by Model-flow(®) and ephedrine (55 ± 3 vs. 74 ± 9 mmHg; 10 mg, n = 9), phenylephrine (51 ± 5 vs. 78 ± 9 mmHg, 0.1 mg, n = 11), adrenaline (53 ± 3 vs. 72 ± 11 mmHg; 1–2 μg, n = 6), noradrenaline (53 ± 5 vs. 72 ± 12 mmHg; 2–4 μg, n = 11), and calcium chloride (49 ± 7 vs. 57 ± 16 mmHg; 5 mmol, n = 10) increased MAP (all P < 0.05). CO increased with ephedrine (4.3 ± 0.9 vs. 5.3 ± 1.2, P < 0.05) and adrenaline (4.7 ± 1.2 vs. 5.9 ± 1.1 l/min; P = 0.07) but was not significantly affected by phenylephrine (3.9 ± 0.7 vs. 3.6 ± 1.0 l/min), noradrenaline (3.8 ± 1.2 vs. 3.7 ± 0.7 l/min), or calcium chloride (4.0 ± 1.4 vs. 4.1 ± 1.5 l/min). Following administration of β-adrenergic agents and calcium chloride rScO(2) was preserved while after administration of α-adrenergic drugs rScO(2) was reduced by app. 2% (P < 0.05). Following α-adrenergic drugs to treat anesthesia-induced hypotension tissue oxygenation is reduced while the use of β-adrenergic agonists and calcium chloride preserve tissue oxygenation. Frontiers Media S.A. 2014-10-22 /pmc/articles/PMC4205832/ /pubmed/25374543 http://dx.doi.org/10.3389/fphys.2014.00407 Text en Copyright © 2014 Kitchen, Nissen, Secher and Nielsen. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Kitchen, Carl-Christian
Nissen, Peter
Secher, Niels H.
Nielsen, Henning B.
Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
title Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
title_full Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
title_fullStr Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
title_full_unstemmed Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
title_short Preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
title_sort preserved frontal lobe oxygenation following calcium chloride for treatment of anesthesia-induced hypotension
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4205832/
https://www.ncbi.nlm.nih.gov/pubmed/25374543
http://dx.doi.org/10.3389/fphys.2014.00407
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