Articles Vol. 65 No. CĐ 9 - Hội Gây mê Hồi sức 26/09/2024

22. EVALUATING CHANGES IN REGIONAL CEREBRAL OXYGEN SATURATION USING NEAR- INFRARED SPECTROSCOPY AND SEVERAL FACTORS RELATED TO REGIONAL CEREBRAL OXYGEN DESATURATION IN PATIENT UNDERGOING CARDIOVASCULAR SURGERY

Nguyen Thi Thuy Ngan1,2, Nguyen Chi Thien3,4, Nguyen Quoc Kinh1,2, Cong Quyet Thang3,4
1 Viet Duc University Hospital
2 Bệnh viện Hữu Nghị Việt Đức
3 Hanoi Medical University
4 Trường Đại học Y Hà Nội
Corresponding author: ngananes@gmail.com
DOI: 10.52163/yhc.v65iCD9.1535
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Keywords
Regional cerebral oxygen saturation cardiovascular surgery near infrared spectroscopy cardiopulmonary bypass
Abstract

Objective: To evaluate changes in regional cerebral oxygen saturation at various time points of surgery and identify several factors related to regional cerebral oxygen desarturation in cardiovascular surgery patients.

Materials and methods: Observational study including 66 patients undergoing cardiovascular surgery with cardiopulmonary bypass using near-infrared spectroscopy as monitoring for regional cerebral oxygen starturation. At different time points of surgery, regional cerebral oxygen starturation, age, history of diseases, hemoglobin concentration, PaO2, mean arterial blood pressure were measured.

Results: The baseline regional cerebral oxygen starturation was 65.32 ± 5.35%. Regional cerebral oxgen saturation increased immediately after anesthesia, reached the lowest value during cardiopulmonary bypass time (58.88 ± 4.60%), then increased and gradually returned to baseline value at the end of surgery. Age greater than or equal to 65 years, history of diabetes, mean arterial blood pressure lower than 50 mmHg and hemoglobin concentration less than 7.5 g/dl during cardiopulmonary bypass are associated with regional cerebral oxygen desarturation.

Conclusion: Regional cerebral oxygen saturation increased immediately after anesthesia, reached the lowest value during cardiopulmonary bypass time. Several factors related to regional cerebral oxygen desarturation include age greater than or equal to 65 years, history of diabetes, mean arterial blood pressure lower than 50 mmHg and hemoglobin concentration less than 7.5 g/dl during cardiopulmonary bypass.

References
[1]
Tan ST, Cerebral oximetry in cardiac surgery, Hong Kong Med J Xianggang Yi Xue Za Zhi, 2008, 14(3): 220-225. Google Scholar
[2]
Casati A, Spreafico E, Putzu M, Fanelli G, New technology for noninvasive brain monitoring: continuous cerebral oximetry, Minerva Anestesiol, 2006, 72(7-8): 605-625. Google Scholar
[3]
Eertmans W, De Deyne C, Genbrugge C et al, Association between postoperative delirium and postoperative cerebral oxygen desaturation Google Scholar
[4]
in older patients after cardiac surgery, Br J Anaesth, 2020, 124(2): 146-153, doi:10.1016/j.bja.2019.09.042. Google Scholar
[5]
Subramanian B, Nyman C, Fritock M et al, A Multicenter Pilot Study Assessing Regional Cerebral Oxygen Desaturation Frequency During Google Scholar
[6]
Cardiopulmonary Bypass and Responsiveness to an Intervention Algorithm, Anesth Analg, 2016, 122(6): 1786-1793, doi:10.1213/ ANE.00000000 00001275. Google Scholar
[7]
Deschamps A, Lambert J, Couture P et al, Reversal of Decreases in Cerebral Saturation in High-Risk Cardiac Surgery, J Cardiothorac Vasc Google Scholar
[8]
Anesth, 2013, 27(6): 1260-1266, doi:10.1053/j.jvca.2013.01.019. Google Scholar
[9]
Singh SP, Choudhury M, Chowdhury UK, Chauhan S, Changes in cerebral oxygenation during coronary artery bypass grafting and its dependence on haematocrit, mean arterial pressure and partial pressure of oxygen in arterial blood, Indian J Clin Anaesth, Published online 2014. Google Scholar
[10]
Mohandas BS, Jagadeesh AM, Vikram SB, Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery, Ann Card Anaesth, 2013, 16(2): 102-106, doi:10.4103/ 0971- 9784. 109740. Google Scholar
[11]
Ngwenya LB, Burke JF, Manley GT, Brain Tissue Oxygen Monitoring and the Intersection of Brain and Lung: A Comprehensive Review, Respir Care, 2016, 61(9): 1232-1244, doi:10.4187/respcare.04962. Google Scholar
[12]
Jo YY, Shim JK, Soh S, Suh S, Kwak YL, Association between Cerebral Oxygen Saturation with Outcome in Cardiac Surgery: Brain as an Google Scholar
[13]
Index Organ, J Clin Med, 2020, 9(3): E840, doi:10.3390/jcm9030840. Google Scholar
[14]
Robu CB, Koninckx A, Docquier MA et al, Advanced Age and Sex Influence Baseline Regional Cerebral Oxygen Saturation as Measured by Near-Infrared Spectroscopy: Subanalysis of a Prospective Study, J Cardiothorac Vasc Anesth, 2020, 34(12): 3282-3289, doi:10.1053/ j.jvca.2020. 06.025. Google Scholar
[15]
Colak Z, Borojević M, Ivancan V, Gabelica R, Biocina B, Majerić-Kogler V, The relationship between prolonged cerebral oxygen desaturation and postoperative outcome in patients undergoing coronary artery bypass grafting, Coll Antropol, 2012, 36(2): 381-388. Google Scholar