Slow rewarming improves jugular venous oxygen saturation during rewarming
Slow rewarming improves jugular venous oxygen saturation during rewarming
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DOI：
10.1034/j.1399-6576.2003.00063.x
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发表时间：
2003-04-01
影响因子：
2.1
通讯作者：
Fujita, N
中科院分区：
文献类型：
--
作者：
Kawahara, F;Kadoi, Y;Fujita, N
背景资料：关于冠状动脉旁路移植术（CABG）术后认知功能障碍的病因已有许多研究。尽管其病因尚未明确，但与术后认知功能障碍相关的一个可能因素是复温期间颈内静脉血氧血红蛋白饱和度（SjvO（2））降低。方法：100例择期CABG手术患者随机分为对照组（0.48 ± 0.09 ℃，n=50）和缓慢复温组（0.24 ± 0.09 ℃，n=50）。麻醉诱导后，将光纤血氧饱和度导管插入右颈静脉球，连续监测SjvO（2）。在9个时间点测量血流动力学参数，动脉和颈静脉血气。结果：在复温过程中，对照组的脑去饱和（定义为SjvO（2）值低于50%）比缓慢组更频繁。对照组的脑氧饱和度下降时间（SjvO（2）<50%时的持续时间）和脑氧饱和度下降时间占CPB总时间的比例与慢速组相比差异有显著性（对照组：17 ± 11 min，12 ± 4%;慢速组：10 ± 8 min，7 ± 4%; P
Background: There have been many studies regarding the etiology of postoperative cognitive dysfunction after coronary artery bypass graft (CABG) surgery. Although its etiology remains unresolved, one possible factor related to postoperative cognitive dysfunction is a reduced internal jugular venous oxygen hemoglobin saturation (SjvO(2)) during the rewarming period. The purpose of this study was to examine the effect of rewarming rates on SjvO(2) during rewarming.Methods: One-hundred patients scheduled for elective CABG surgery were randomly divided into two groups; control group (0.48+/-0.09degreesC, n=50), slow rewarming group (0.24+/-0.09degreesC, n=50). After the induction of anesthesia, a fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to monitor SjvO(2) continuously. Hemodynamic parameters, arterial and jugular venous blood gases were measured at nine time-points.Results: Cerebral desaturation (defined as a SjvO(2) value below 50%) during rewarming was more frequent in the control group than in the slow group. Cerebral desaturation time (duration when SjvO(2) was less than 50%) and the ratio of the cerebral desaturation time to the total CPB time in the control group differed significantly from those in the slow group (control group: 17+/-11 min, 12+/-4%, slow group: 10+/-8 min, 7+/-4%, respectively, P