Izvorni znanstveni članak
The Relationship between Prolonged Cerebral Oxygen Desaturation and Postoperative Outcome in Patients Undergoing Coronary Artery Bypass Grafting
Željko Čolak
Marko Borojević
Višnja Ivančan
Rajka Gabelica
Bojan Biočina
Višnja Majerić-Kogler
Sažetak
58 patients who underwent on-pump coronary artery bypass graft surgery were evaluated for changes in regional cerebral
oxygen saturation (rSO2) measured by near infrared spectroscopy (NIRS). If rSO2 during the operation fell to
more than 20% under the baseline, standardized interventions were undertaken to maintain rSO2. Despite those interventions,
in some cases we observed inability to maintain rSO2 above this threshold. Therefore we divided patients in two
subgroups: 1. without prolonged rSO2 desaturation; 2. with prolonged rSO2 desaturation (area under the curve >150
min% for rSO2<20% of baseline and >50 min% for rSO2<50% of absolute value). The data were analyzed to determine
whether there were major differences in outcome of these two groups. 18 out of 58 patients (31%) had prolonged rSO2
desaturation during operation. There was significantly higher number of diabetic patients in group with prolonged rSO2
desaturation (p=0.02). Intraoperative data revealed significantly more blood consumption during cardiopulmonary bypass
(p=0.007) and the need for inotropes (p=0.04) in desaturation group. Three patients in prolonged desaturation
group and no one in another group had stroke, coma or stupor (p=0.03). Logistic regression analysis revealed diabetes
mellitus and age as predictors for prolonged rSO2 desaturation. We concluded that prolonged intraoperative rSO2 desaturation
is significantly associated with worse neurological outcome in patients – nonresponders to standardized interventions
for prevention of rSO2 desaturation.
Ključne riječi
cerebral oximetry; near-infrared spectroscopy; on-pump coronary artery bypass; neurologic outcome
Hrčak ID:
84773
URI
Datum izdavanja:
10.7.2012.
Posjeta: 923 *