The effect of hyperventilation versus normoventilation on cerebral oxygenation using near infrared spectroscopy in children undergoing posterior fossa tumor resection: A randomized controlled cross-over trial

This study aims to compare the effect of two different ventilation strategies on cerebral oxygenation in children undergoing posterior fossa tumor excision surgeries. Children scheduled for posterior fossa tumor surgeries were enrolled in this randomized, double-blinded, controlled cross-over trial....

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Published in:Anaesthesia critical care & pain medicine 2023-06, Vol.42 (3), p.101190-101190, Article 101190
Main Authors: Sarhan, Khaled Abdelfattah, Emad, Reham, Mahmoud, Dina, Hasanin, Ahmed, Hosny, Osama, Al-Sonbaty, Mohamed, Abo El-Ela, Amel, Othman, Safinaz
Format: Article
Language:English
Subjects:
Brain Neoplasms - surgery
Cerebral oximetry
Child
Children
Cross-Over Studies
Humans
Hyperventilation
Infratentorial Neoplasms - surgery
Near infrared spectroscopy
Oxygen
Posterior fossa
Spectroscopy, Near-Infrared - methods
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creator Sarhan, Khaled Abdelfattah
Emad, Reham
Mahmoud, Dina
Hasanin, Ahmed
Hosny, Osama
Al-Sonbaty, Mohamed
Abo El-Ela, Amel
Othman, Safinaz
description This study aims to compare the effect of two different ventilation strategies on cerebral oxygenation in children undergoing posterior fossa tumor excision surgeries. Children scheduled for posterior fossa tumor surgeries were enrolled in this randomized, double-blinded, controlled cross-over trial. After induction of general anesthesia and positioning, participants were randomized to have mild hyperventilation for 30 min (phase 1) followed by normal ventilation for another 30 min (phase2) (early hyperventilation group, n = 23), or normal ventilation for 30 min (phase 1) followed by hyperventilation for 30 min (phase 2) (early normoventilation group, n = 19). Our primary outcome was cerebral oxygenation, measured using near-infrared spectroscopy (NIRS). Other outcomes included the intracranial pressure (ICP), brain relaxation score at the end of phase 1, and frequency of nadir NIRS. Forty-two children were available for final per protocol analysis. The cerebral oxygenation decreased after the hyperventilation phase compared to the baseline values and the corresponding phases of normoventilation. The mean difference [95% confidence intervals (CI)] in cerebral oxygen saturation between the hyperventilation and normal ventilation readings was 13.45 ± 1.14% [11.14–15.76] and 11.47 ± 0.96% [11.14–15.76] in the left and right sides, respectively (p-values
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The mean difference [95% confidence intervals (CI)] in cerebral oxygen saturation between the hyperventilation and normal ventilation readings was 13.45 ± 1.14% [11.14–15.76] and 11.47 ± 0.96% [11.14–15.76] in the left and right sides, respectively (p-values &lt;0.0001). Both carryover and period effects were not significant. The ICP at the end of phase 1 did not differ between the two groups: 22.12 ± 3.75 mmHg vs. 23.26 ± 4.33, mean difference [95%CI]: −0.78 [−3.05 to 1.5], p = 0.49. Brain relaxation score was similar in the two groups. 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Children scheduled for posterior fossa tumor surgeries were enrolled in this randomized, double-blinded, controlled cross-over trial. After induction of general anesthesia and positioning, participants were randomized to have mild hyperventilation for 30 min (phase 1) followed by normal ventilation for another 30 min (phase2) (early hyperventilation group, n = 23), or normal ventilation for 30 min (phase 1) followed by hyperventilation for 30 min (phase 2) (early normoventilation group, n = 19). Our primary outcome was cerebral oxygenation, measured using near-infrared spectroscopy (NIRS). Other outcomes included the intracranial pressure (ICP), brain relaxation score at the end of phase 1, and frequency of nadir NIRS. Forty-two children were available for final per protocol analysis. The cerebral oxygenation decreased after the hyperventilation phase compared to the baseline values and the corresponding phases of normoventilation. 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source ScienceDirect Journals
subjects Brain Neoplasms - surgery
Cerebral oximetry
Child
Children
Cross-Over Studies
Humans
Hyperventilation
Infratentorial Neoplasms - surgery
Near infrared spectroscopy
Oxygen
Posterior fossa
Spectroscopy, Near-Infrared - methods
title The effect of hyperventilation versus normoventilation on cerebral oxygenation using near infrared spectroscopy in children undergoing posterior fossa tumor resection: A randomized controlled cross-over trial
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