Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery

Aims and Objectives: We studied the usefulness of regional cerebral oxygen saturation (rSO 2 ) monitoring during cardiopulmonary bypass (CPB) and evaluated effects of cerebral oxygen desaturation on the postoperative neurological outcome. Materials and Methods: 100 patients were randomly allocated t...

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Bibliographic Details
Published in:Annals of cardiac anaesthesia 2013-04, Vol.16 (2), p.102-106
Main Authors: Mohandas, B, Jagadeesh, A, Vikram, S
Format: Article
Language:English
Subjects:
Anesthesia
Antisaccadic eye movement test
Cardiopulmonary bypass
Cerebral circulation
Cerebral oximetry
Cognition
Cognitive ability
Cognitive dysfunction
Heart
Heart surgery
Intervention
Mini-mental state examination
Mortality
Patients
Physiological aspects
Postoperative period
Surgery
Testing
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Summary:Aims and Objectives: We studied the usefulness of regional cerebral oxygen saturation (rSO 2 ) monitoring during cardiopulmonary bypass (CPB) and evaluated effects of cerebral oxygen desaturation on the postoperative neurological outcome. Materials and Methods: 100 patients were randomly allocated to either control or intervention group. In the control group rSO 2 was recorded continuously, but the attending anesthesiologist was blinded. In the intervention group specific interventions were initiated in case of cerebral desaturation. Neurocognitive testing was done using a simplified antisaccadic eye movement test (ASEM) and mini-mental state examination (MMSE). Data was analyzed using Chi-square test, and unpaired t-test. Results: In both the groups rSO 2 declined during CPB. The decrease in rSO 2 was significant ( P < 0.001) in the control group compared to the intervention group. In the intervention group the rSO 2 mainly responded to an increase in mean arterial pressure. The area under the curve below threshold rSO 2 was significantly more ( P < 0.0001) in the control group compared to intervention group and a significant decrease in the MMSE and ASEM scores occurred in control group at one week and three months postoperatively. Conclusions: Monitoring of rSO 2 during CPB can significantly decrease the incidence of postoperative neurocognitive decline.
ISSN:0971-9784
0974-5181
DOI:10.4103/0971-9784.109740