Sustained erroneous near-infrared cerebral oxygen saturation in alert icteric patient with vanishing bile duct syndrome during and after liver transplantation: A case report.
10.17085/apm.2019.14.1.63
- Author:
Yang Hoon CHUNG
1
;
So Jeong LEE
;
Bon Sung KOO
;
Ana CHO
;
Misoon LEE
;
Junwoo PARK
;
Sang Hyun KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. skim@schmc.ac.kr
- Publication Type:Case Report
- Keywords:
Bilirubin;
Brain hypoxia;
Hyperbilirubinemia;
Liver transplantation;
Nearinfrared spectroscopy;
Oxymetry
- MeSH:
Bile Ducts*;
Bile*;
Bilirubin;
Diagnosis;
Humans;
Hyperbilirubinemia;
Hypoxia, Brain;
Liver Transplantation*;
Liver*;
Oxygen*;
Perioperative Period;
Postoperative Period;
Skin Pigmentation;
Spectrum Analysis;
Transplant Recipients
- From:Anesthesia and Pain Medicine
2019;14(1):63-66
- CountryRepublic of Korea
- Language:English
-
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 SpO2₂ 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.
