Korean J Anesthesiol.  2010 Feb;58(2):191-196. 10.4097/kjae.2010.58.2.191.

Cerebral oximetry monitoring during aortic arch aneurysm replacement surgery in Jehovah's Witness patient -A case report-

• Kim SH
• Yoon TG
• Kim TY
• Kim HK
• Sung WS

• KMID: 2092276
• DOI: http://doi.org/10.4097/kjae.2010.58.2.191

Abstract

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.

Keyword

Aortic arch aneurysm; Cerebral oximetry; Jehovah's Witness

MeSH Terms

Aneurysm
Aorta, Thoracic
Brain Ischemia
Circulatory Arrest, Deep Hypothermia Induced
Disulfiram
Hemodilution
Humans
Oximetry
Spectrum Analysis
Wit and Humor as Topic
Disulfiram