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Changes of jugular venous blood temperature associated with measurements of cerebral blood flow using the transcerebral double-indicator dilution technique

Published online by Cambridge University Press:  23 December 2004

F. Mielck ,
A. Bräuer ,
O. Radke ,
G. Hanekop ,
S. Loesch ,
M. Friedrich ,
R. Hilgers  and
H. Sonntag
F. Mielck
Affiliation:
University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany
A. Bräuer
Affiliation:
University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany
O. Radke
Affiliation:
University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany
G. Hanekop
Affiliation:
University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany
S. Loesch
Affiliation:
University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany
M. Friedrich
Affiliation:
University of Göttingen, Department of Cardiothoracic and Vascular Surgery, Göttingen, Germany
R. Hilgers
Affiliation:
University of Göttingen, Department of Medical Statistics, Göttingen, Germany
H. Sonntag
Affiliation:
University of Göttingen, Department of Anaesthesiology, Emergency and Intensive Care Medicine, Göttingen, Germany
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Extract

Summary

Background and objective: The transcerebral double-indicator dilution technique is a recently developed method to measure global cerebral blood flow at bedside. It is based on bolus injection of ice-cold indocyanine green dye and simultaneous recording of resulting thermo- and dye-dilution curves in the aorta and the jugular bulb. However, with this method 40 mL of ice-cold solution is administered as a bolus. Therefore, this prospective clinical study was performed to elucidate the effects of repeated administration of indicator on absolute blood temperature and on cerebral blood flow and metabolism.

Methods: The investigation was performed in nine male patients scheduled for elective coronary artery bypass grafting. Absolute blood temperature was measured in the jugular bulb and in the aorta before and after repeated measurements using the transcerebral double-indicator dilution technique.

Results: During the investigated time course, the blood temperature in the jugular bulb, compared to the aorta, was significantly higher with a mean difference of 0.21°C. The administration of an ice-cold bolus reduced the mean blood temperature by 0.06°C in the jugular bulb as well as in the aorta. After the transcerebral double-indicator dilution measurements a temperature recovery to baseline conditions was not observed during the investigated time period. Cerebral blood flow and cerebral metabolism did not change during the investigated time period.

Conclusions: Repeated measurements with the transcerebral double-indicator dilution technique do not affect absolute jugular bulb blood temperatures negatively. Global cerebral blood flow and metabolism measurements remain unaltered. However, accuracy and resolution of this technique is not high enough to detect the effect of minor changes of physiological variables.

Keywords

HAEMODYNAMICS, regional blood flow, cerebral blood flowINVESTIGATIVE TECHNIQUES, indicator dilution techniques, dye-dilution technique, thermo-dilutionTEMPERATURE, jugular bulb
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 4 , April 2004 , pp. 289 - 295
Copyright
2004 European Society of Anaesthesiology

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