| Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. | |
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MedLine Citation:
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PMID: 17179242 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Cerebral deoxygenation is associated with various adverse systemic outcomes. We hypothesized, by using the brain as an index organ, that interventions to improve cerebral oxygenation would have systemic benefits in cardiac surgical patients. METHODS: Two-hundred coronary artery bypass patients were randomized to either intraoperative cerebral regional oxygen saturation (rSO2) monitoring with active display and treatment intervention protocol (intervention, n = 100), or underwent blinded rSO2 monitoring (control, n = 100). Predefined clinical outcomes were assessed by a blinded observer. RESULTS: Significantly more patients in the control group demonstrated prolonged cerebral desaturation (P = 0.014) and longer duration in the intensive care unit (P = 0.029) versus intervention patients. There was no difference in overall incidence of adverse complications, but significantly more control patients had major organ morbidity or mortality (death, ventilation >48 h, stroke, myocardial infarction, return for re-exploration) versus intervention group patients (P = 0.048). Patients experiencing major organ morbidity or mortality had lower baseline and mean rSO2, more cerebral desaturations and longer lengths of stay in the intensive care unit and postoperative hospitalization, than patients without such complications. There was a significant (r(2) = 0.29) inverse correlation between intraoperative rSO2 and duration of postoperative hospitalization in patients requiring > or =10 days postoperative length of stay. CONCLUSION: Monitoring cerebral rSO2 in coronary artery bypass patients avoids profound cerebral desaturation and is associated with significantly fewer incidences of major organ dysfunction. |
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Authors:
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John M Murkin; Sandra J Adams; Richard J Novick; Mackenzie Quantz; Daniel Bainbridge; Ivan Iglesias; Andrew Cleland; Betsy Schaefer; Beverly Irwin; Stephanie Fox |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anesthesia and analgesia Volume: 104 ISSN: 1526-7598 ISO Abbreviation: Anesth. Analg. Publication Date: 2007 Jan |
Date Detail:
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Created Date: 2006-12-20 Completed Date: 2007-01-23 Revised Date: 2007-08-20 |
Medline Journal Info:
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Nlm Unique ID: 1310650 Medline TA: Anesth Analg Country: United States |
Other Details:
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Languages: eng Pagination: 51-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology and Perioperative Medicine, University Hospital-LHSC, University of Western Ontario, London, Ontario, Canada. jmurkin@uwo.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Brain / metabolism* Cardiopulmonary Bypass* Carotid Artery Diseases / epidemiology Coronary Artery Bypass* Humans Informed Consent Intraoperative Care* Monitoring, Intraoperative* Monitoring, Physiologic Myocardial Infarction / surgery Oxygen Consumption* Prospective Studies |
| Comments/Corrections | |
Comment In:
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Anesth Analg. 2007 Aug;105(2):537-8; author reply 538-9
[PMID:
17646525
]
Anesth Analg. 2007 Aug;105(2):536-7; author reply 538-9 [PMID: 17646524 ] Anesth Analg. 2007 Aug;105(2):537; author reply 538-9 [PMID: 17646526 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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