Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery

Fun Sun F. Yao, Chia Chih A. Tseng, Chee Yueh A. Ho, Serle K. Levin, Pavel Illner

研究成果: Article同行評審

275 引文 斯高帕斯(Scopus)

摘要

Objective: To evaluate the relationship between cerebral oxygen saturation and neuropsychological dysfunction after cardiac surgery. Design: Prospective and observational study. Setting: Operating room and cardiac floor of a university hospital. Participants: One hundred one patients undergoing elective cardiac surgery with cardiopulmonary bypass Intervention: Bilateral noninvasive cerebral oxygen saturations were monitored over the forehead. The anesthetic and surgical techniques were performed as usual, and no interventions were attempted based on the monitor. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE) and the antisaccadic eye movement test (ASEM). Measurements and Main Results: Preoperative baseline values of cerebral oxygen saturation (rSO2) were 58.6% ± 10.2%. Patients with the nadir rSO2 <35% had significantly higher incidences of postoperative ASEM and MMSE impairments than those with rSO2 always above 35% (44% and 33% v 12% and 9%, respectively). Patients with areas of rSO2 <40% for more than 10 minutes·% presented with a significantly higher incidence of postoperative ASEM and MMSE impairments than those with areas of rSO2 <40% for less than 10 minutes·% (42% and 32% v 13% and 10%, respectively). Patients with postoperative ASEM or MMSE impairment had significantly lower nadir rSO2 and significantly larger areas of rSO2 <40%, <45%, and <50% than those with normal postoperative neuropsychological outcome. However, multivariate logistic regression analysis showed that areas of rSO2 <40% were the only predictor for both postoperative ASEM and MMSE impairments. Conclusions: Intraoperative cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery with cardiopulmonary bypass. However, it remains to be determined whether interventions to maintain adequate cerebral oxygenation may improve neuropsychological outcome.

原文English
頁(從 - 到)552-558
頁數7
期刊Journal of Cardiothoracic and Vascular Anesthesia
18
發行號5
DOIs
出版狀態Published - 2004 十月

All Science Journal Classification (ASJC) codes

  • 心臟病學與心血管醫學
  • 麻醉與疼痛醫學

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