- 作者：Emilie de Tournay-Jetté ; PhD ; Gilles Dupuis PhD ; † ; ; dupuis.gilles@uqam.ca ; Louis Bherer PhD ; ‡ ; ; Alain Deschamps MD ; PhD† ; ; Raymond Cartier MD† ; ; André ; Denault MD ; PhD ; FASE† ;
- 关键词：cognitive dysfunction ; cerebral oximetry ; coronary artery bypass graft surgery ; elderly
- 刊名：Journal of Cardiothoracic and Vascular Anesthesia
- 出版年：2011
- 出版时间：February 2011
- 年：2011
- 卷：25
- 期：1
- 页码：95-104
- 全文大小：547 K
lass=""h4"">Objective
The aim of this study was to evaluate the predictive value of cerebral regional oxygen saturation (rSO2) in the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing coronary artery bypass graft (CABG) surgery.lass=""h4"">Design
A prospective study.
lass=""h4"">Setting
University hospital.
lass=""h4"">Participants
A total of 61 patients (84 % male) with a mean age of 70.39 ± 4.69 on a waiting list for CABG surgery were enrolled in the study.
lass=""h4"">Intervention
A complete neurocognitive evaluation was performed 1 day before surgery as well as 4 to 7 days and 1 month after surgery. During surgery, rSO2 was monitored continuously.
lass=""h4"">Measurements and Main Results
POCD was defined as a reduction of 1 standard deviation on 2 or more neuropsychologic indices. Forty-six patients (80.7 % ) developed early POCD, and 23 (38.3 % ) showed late POCD. Patients whose rSO2 decreased to less than 50 % during the surgery experienced more POCD 4 to 7 days after surgery (p = 0.04). In addition, a decrease of more than 30 % from the patient's baseline rSO2 was associated with POCD 1 month after surgery (p = 0.03).
lass=""h4"">Conclusion
Intraoperative cerebral oxygen desaturation is associated with early and late POCD in elderly patients. Cerebral oximetry is a promising tool in the prediction of subtle neuropsychologic deficits and further studies are needed.