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Sustained erroneous near-infrared cerebral oxygen saturation in alert icteric patient with vanishing bile duct syndrome during and after liver transplantation - A case report -
Anesth Pain Med 2019;14(1):63-6
Published online January 31, 2019
© 2019 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Yang Hoon Chung , So Jeong Lee , Bon Sung Koo , Ana Cho , Misoon Lee , Junwoo Park , and Sang Hyun Kim
Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
Correspondence to: Corresponding author Sang Hyun Kim, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon 14584, Korea Tel: 82-32-621-6480 Fax: 82-32-621-5322 E-mail: skim@schmc.ac.kr
Received May 17, 2018; Revised June 22, 2018; Accepted July 6, 2018.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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 SpO2 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.

Key Words : Bilirubin, Brain hypoxia, Hyperbilirubinemia, Liver transplantation, Near-infrared spectroscopy, Oxymetry


April 2019, 14 (2)
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