Document Detail


The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery.
MedLine Citation:
PMID:  20650659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to evaluate the predictive value of cerebral regional oxygen saturation (rSO(2)) in the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing coronary artery bypass graft (CABG) surgery.
DESIGN: A prospective study.
SETTING: University hospital.
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.
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, rSO(2) was monitored continuously.
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 rSO(2) 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 rSO(2) was associated with POCD 1 month after surgery (p = 0.03).
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.
Authors:
Emilie de Tournay-Jetté; Gilles Dupuis; Louis Bherer; Alain Deschamps; Raymond Cartier; André Denault
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Publication Detail:
Type:  Journal Article     Date:  2010-07-22
Journal Detail:
Title:  Journal of cardiothoracic and vascular anesthesia     Volume:  25     ISSN:  1532-8422     ISO Abbreviation:  J. Cardiothorac. Vasc. Anesth.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-05-18     Revised Date:  2012-01-05    
Medline Journal Info:
Nlm Unique ID:  9110208     Medline TA:  J Cardiothorac Vasc Anesth     Country:  United States    
Other Details:
Languages:  eng     Pagination:  95-104     Citation Subset:  IM    
Copyright Information:
Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Algorithms
Anesthesia, General
Brain Chemistry / physiology*
Cognition Disorders / psychology*
Coronary Artery Bypass / psychology*
Educational Status
Female
Humans
Male
Mental Disorders / complications
Neuropsychological Tests
Oximetry
Oxygen Consumption / physiology*
Postoperative Complications / metabolism*,  psychology*
Preanesthetic Medication
Predictive Value of Tests
Prospective Studies
Spectroscopy, Near-Infrared
Comments/Corrections
Comment In:
J Cardiothorac Vasc Anesth. 2011 Dec;25(6):e52-3; author reply e53-4   [PMID:  21835641 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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