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KMID : 0356920100580020191
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Korean Journal of Anesthesiology
2010 Volume.58 No. 2 p.191 ~ p.196
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Cerebral oximetry monitoring during aortic arch aneurysm replacement surgery in Jehovah’s Witness patient -A case report-
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Kim Sung-Hub
Yoon Tae-Gyoon
Kim Tae-Yop
Kim Hae-Kyoung
Seong Woo-Seong
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Abstract
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Anesthetic management for aortic arch aneurysm (AAA) surgery employing deep hypothermic circulatory arrest in a Jehovah’s Witness (JW) patient is a challenge to anesthesiologist due to its complexity of procedures and their refusal of allogeneic transfusion. Even in the strict application of intraoperative acute normovolemic hemodilution (ANH) and intraopertive cell salvage (ICS) technique, prompt timing of re-administration of salvaged blood is essential for successful operation without allogeneic transfusion or ischemic complication of major organs. Cerebral oximetery (rSO2) monitoring using near infrared spectroscopy is a useful modality for detecting cerebral ischemia during the AAA surgery requiring direct interruption of cerebral flow. The present case showed that rSO2 can be used as a trigger facilitating to find a better timing for the re-administration of salvaged blood acquired during the AAA surgery for JW patient.
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KEYWORD
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Aortic arch aneurysm, Cerebral oximetry, Jehovah’s Witness
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