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KMID : 1155520190140010063
Anesthesia and Pain Medicine
2019 Volume.14 No. 1 p.63 ~ p.66
Sustained erroneous near-infrared cerebral oxygen saturation in alert icteric patient with vanishing bile duct syndrome during and after liver transplantation - A case report -
Chung Yang-Hoon

Lee So-Jeong
Koo Bon-Sung
Cho A-Na
Lee Mi-Soon
Park Jun-Woo
Kim Sang-Hyun
Abstract
Monitoring cerebral oxygenation using a near infrared spectroscopy (NIRS) device is useful for estimating cerebral hypoperfusion and is available during liver transplantation (LT). However, high serum bilirubin concentration can interfere with NIRS because bilirubin absorbs near infrared light. We report a patient who underwent LT with a diagnosis of vanishing bile duct syndrome, whose regional cerebral oxygen saturation (rSO2) remained below 15% even with alert mental status and SpO2 value of 99%. The rSO2 values were almost fixed at the lowest measurable level throughout the intra- and postoperative period. We report a case of erroneously low rSO2 values during the perioperative period in a liver transplant recipient which might be attributable to skin pigmentation rather than higher serum bilirubin concentration.
KEYWORD
Bilirubin, Brain hypoxia, Hyperbilirubinemia, Liver transplantation, Nearinfrared spectroscopy, Oxymetry
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