Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery
Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery
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DOI：
10.4103/0971-9784.109740
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发表时间：
2013-04-01
影响因子：
0.9
通讯作者：
Vikram, S. B.
中科院分区：
文献类型：
--
作者：
Mohandas, B. S.;Jagadeesh, A. M.;Vikram, S. B.
目的和目的：我们研究了体外循环（CPB）期间局部脑氧饱和度（rSO（2））监测的有用性，并评估了脑氧饱和度降低对术后神经系统结果的影响。材料和方法：100 名患者被随机分配到对照组或干预组。在对照组中，rSO(2)被连续记录，但主治麻醉师是不知情的。在干预组中，针对脑饱和度降低的情况启动了特定的干预措施。使用简化的抗眼跳眼动测试（ASEM）和简易精神状态检查（MMSE）进行神经认知测试。使用卡方检验和未配对 t 检验分析数据。结果：两组中 rSO(2) 在 CPB 期间均下降。与干预组相比，对照组的 rSO(2) 下降显着（P < 0.001）。在干预组中，rSO(2) 主要对平均动脉压的增加做出反应。与干预组相比，对照组低于阈值rSO（2）的曲线下面积显着更大（P < 0.0001），并且术后1周和3个月对照组的MMSE和ASEM评分显着下降。结论：CPB 期间监测 rSO(2) 可显着降低术后神经认知下降的发生率。
Aims and Objectives: We studied the usefulness of regional cerebral oxygen saturation (rSO(2) ) monitoring during cardiopulmonary bypass (CPB) and evaluated effects of cerebral oxygen desaturation on the postoperative neurological outcome. Materials and Methods: 100 patients were randomly allocated to either control or intervention group. In the control group rSO(2) was recorded continuously, but the attending anesthesiologist was blinded. In the intervention group specific interventions were initiated in case of cerebral desaturation. Neurocognitive testing was done using a simplified antisaccadic eye movement test (ASEM) and mini-mental state examination (MMSE). Data was analyzed using Chi-square test, and unpaired t-test. Results: In both the groups rSO(2) declined during CPB. The decrease in rSO(2) was significant (P < 0.001) in the control group compared to the intervention group. In the intervention group the rSO(2) mainly responded to an increase in mean arterial pressure. The area under the curve below threshold rSO(2) was significantly more (P < 0.0001) in the control group compared to intervention group and a significant decrease in the MMSE and ASEM scores occurred in control group at one week and three months postoperatively. Conclusions: Monitoring of rSO(2) during CPB can significantly decrease the incidence of postoperative neurocognitive decline.