Continuous, Non-invasive Monitoring of Intraoperative Cerebral Perfusion and Oxidative Metabolism (CPOM)

Study Overview
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Brief Summary
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This study uses a CPOM Optical neuromonitor to assess the relationship between brain cytochrome C oxidase, cerebral oxygen saturation and blood pressure during surgery performed under general anesthesia.

Detailed Description
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During various surgical procedures, blood supply to the brain can be jeopardized either due to interruption of flow as occurs during carotid surgery, or due to inadequate arterial pressure which can occur in settings as diverse as heart surgery or shoulder surgery. This is a prospective observational study of brain oxygen levels, brain metabolism and blood pressure in 40 adult surgical patients under general anesthesia using a CPOM Optical neuromonitor. This is an observational study. The primary objective of this study is to describe the changes in redox state of brain CCO (reflecting oxidative metabolism), CBFi, and brain tissue oxygen saturation in relation to systemic blood pressure in patients during the transition from the awake state to general anesthesia. This study represents the first opportunity to assess this combined technology in adult patients and will provide important pilot data to support further investigations in brain-at-risk patients. These 40 patients will be used to help the investigators to obtain pilot data about the relationship between brain cytochrome C oxidase (bCCO), cerebral oxygen saturation (ScO2), and blood pressure using a CPOM device. No intervention will be applied.

Official Title
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Continuous, Non-invasive Monitoring of Intraoperative Cerebral Perfusion and Oxidative Metabolism (CPOM): a Knowledge Translation Study.

Conditions
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Brain Hypoxia Ischemia

Intervention / Treatment
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* Device: CPOM Optical Neuromonitor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult surgical patients (>18 year-old) who require general anesthesia for their surgery Patients required an arterial line for his/her procedure Exclusion Criteria: Emergency surgery Unable to obtain consent Condition that preclude the use of CPOM monitor (e.g. skin lesion in the forehead)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: CPOM Optical Neuromonitor|Prior to induction of anesthesia, the CPOM monitor will be secured to the temporal region of the participant's forehead to measure and record the cerebral hemodynamic data before, during, and following intubation. Hemodynamic, respiratory, body temperature, and anesthetic data will be continuously digitally records. The CPOM device will be detached after extubation in the operative room.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain cytochrome C oxidase level. | The cytochrome C oxidase level which reflects the brain oxidative metabolism will be measured by a CPOM Optical Neuromonitor. | Intraoperative | 
| Brain saturation (ScO2) | The brain saturation (ScO2) (%) will be measured by a CPOM Optical Neuromonitor. | Intraoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Intraoperative/methods* Oximetry/methods* Oxygen/metabolism, brain/metabolism, brain chemistry, cerebrovascular circulation, humans, monitoring, intraoperative/methods, oximetry/methods, oxygen/metabolism