Cerebral Oxygen Saturation and Negative Postoperative Behavioral Changes in Pediatric Surgery: A Prospective Observational Study
Cerebral Oxygen Saturation and Negative Postoperative Behavioral Changes in Pediatric Surgery: A Prospective Observational Study
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DOI：
10.1016/j.jpeds.2018.12.047
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发表时间：
2019-05-01
影响因子：
5.1
通讯作者：
Tamayo, Eduardo
中科院分区：
文献类型：
--
作者：
Gomez-Pesquera, Estefania;Poves-Alvarez, Rodrigo;Tamayo, Eduardo
Objective To evaluate if an intraoperative cerebral regional oxygen saturation (crSO(2)) decrease, less pronounced than 20% below baseline (the current threshold believed to be associated with cognitive dysfunction in adults), is associated with negative postoperative behavioral changes (NPOBC) in the pediatric population after noncardiac surgeries.Study design A prospective observational study was conducted with 198 children aged 2-12 years old scheduled for noncardiac procedures under general anesthesia. Intraoperatively, crSO(2) was monitored with a cerebral oximeter. On postoperative day 7, the Post-Hospital Behavior Questionnaire was used to diagnose NPOBC.Results The incidence of NPOBC was 38.8%. Logistic regression analysis revealed that with every 1% reduction of crSO(2) from the baseline value, the odds of developing NPOBC were 1.199 higher. Likewise, preoperative anxiety (OR 2.832, P = .006), duration of surgery (OR 1.026, P < .0001), and being between the ages of 2 and 3 years (OR 2.604, P = .048) were associated with NPOBC incidence. The multivariable logistic regression model receiver operating characteristic curve showed an area under the curve (95% CI) = 0.820 (0.759-0.881).Conclusions During noncardiac surgeries in the pediatric population, an intraoperative decrease in crSO(2) less pronounced than 20% from the baseline value is associated with negative postoperative behavior changes on postoperative day 7. The long-term implications remain to be determined, but this supports attention to crSO(2) during noncardiac surgeries.
