The influence of oxygen delivery during cardiopulmonary bypass on the incidence of delirium in CABG patients; a retrospective study.
The influence of oxygen delivery during cardiopulmonary bypass on the incidence of delirium in CABG patients; a retrospective study.
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DOI：
10.1177/0267659118783104
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Golab H
中科院分区：
文献类型：
--
作者：
Leenders J;Overdevest E;van Straten B;Golab H
术后谵妄是心脏手术最常见的神经系统并发症。缺氧已被证明会增加术后谵妄的风险。在体外循环（CPB）期间持续监测氧输送（DO2）的可能性提供了对患者氧状态的适当近似。本研究探讨体外循环中供氧在术后谵妄发生率中的作用。357名接受正常冠状动脉旁路移植术（CABG）的成年患者被纳入这项回顾性研究。确定了旁路时的最低点指数DO2i值、临界DO2i水平下的总时间和临界DO2i曲线下面积（AUC）。术后给予氟哌啶醇确认谵妄。术后谵妄组与无谵妄组的平均最低点DO2i差异有统计学意义。多变量分析仅确定年龄、已有认知障碍、术前肾功能障碍和交叉钳夹时间为谵妄的独立危险因素。结果还表明，年龄越大的患者对DO2i下降越敏感。体外循环期间低DO2i与CABG患者术后谵妄发生率显著相关。然而，DO2作为谵妄的独立预测因子的作用尚未得到证实。
Postoperative delirium is the most common neurological complication of cardiac surgery. Hypoxia has been shown to increase the risk of postoperative delirium. The possibility to continuously monitor oxygen delivery (DO2) during cardiopulmonary bypass (CPB) offers an adequate approximation of the oxygen status in a patient. This study investigates the role of oxygen delivery during cardiopulmonary bypass in the incidence of postoperative delirium. Three hundred and fifty-seven adult patients who underwent normothermic coronary artery bypass grafting (CABG) surgery were included in this retrospective study. The nadir indexed DO2 (DO2i) value on bypass, the total time under the critical DO2i level and the area under the curve (AUC) for critical DO2i were determined. Delirium was identified by the postoperative administration of haloperidol. The mean nadir DO2i significantly differed, comparing the group of patients with postoperative delirium to the group without. Multivariate analysis only identified age, pre-existing cognitive impairment, preoperative kidney dysfunction and cross-clamp time as independent risk factors for delirium. The results also indicated that patients of older age were more sensitive to a declined DO2i. A low DO2i during cardiopulmonary bypass is significantly associated with the incidence of postoperative delirium in CABG patients. However, the role of DO2 as an independent predictor of delirium could not be proven.
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影响因子：
14.5
作者：
LEENDERS, KL;PERANI, D;JONES, T
通讯作者：
JONES, T
影响因子：
6.7
作者：
Maclullich AM;Anand A;Davis DH;Jackson T;Barugh AJ;Hall RJ;Ferguson KJ;Meagher DJ;Cunningham C
通讯作者：
Cunningham C
影响因子：
168.9
作者：
Inouye, Sharon K.;Westendorp, Rudi G. J.;Saczynski, Jane S.
通讯作者：
Saczynski, Jane S.
影响因子：
4.6
作者：
Ranucci, M;Romitti, F;Ditta, A
通讯作者：
Ditta, A
影响因子：
4.7
作者：
Kazmierski, Jakub;Kowman, Maciej;Kloszewska, Iwona
通讯作者：
Kloszewska, Iwona