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Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery

Objective: To evaluate the relationship between cerebral oxygen saturation and neuropsychological dysfunction after cardiac surgery. Design: Prospective and observational study. Setting: Operating room and cardiac floor of a university hospital. Participants: One hundred one patients undergoing elec...

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Published in:Journal of cardiothoracic and vascular anesthesia 2004-10, Vol.18 (5), p.552-558
Main Authors: Yao, Fun-Sun F., Tseng, Chia-Chih A., Ho, Chee-Yueh A., Levin, Serle K., Illner, Pavel
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container_title Journal of cardiothoracic and vascular anesthesia
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description Objective: To evaluate the relationship between cerebral oxygen saturation and neuropsychological dysfunction after cardiac surgery. Design: Prospective and observational study. Setting: Operating room and cardiac floor of a university hospital. Participants: One hundred one patients undergoing elective cardiac surgery with cardiopulmonary bypass Intervention: Bilateral noninvasive cerebral oxygen saturations were monitored over the forehead. The anesthetic and surgical techniques were performed as usual, and no interventions were attempted based on the monitor. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE) and the antisaccadic eye movement test (ASEM). Measurements and Main Results: Preoperative baseline values of cerebral oxygen saturation (rSO 2) were 58.6% ± 10.2%. Patients with the nadir rSO 2
doi_str_mv 10.1053/j.jvca.2004.07.007
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Design: Prospective and observational study. Setting: Operating room and cardiac floor of a university hospital. Participants: One hundred one patients undergoing elective cardiac surgery with cardiopulmonary bypass Intervention: Bilateral noninvasive cerebral oxygen saturations were monitored over the forehead. The anesthetic and surgical techniques were performed as usual, and no interventions were attempted based on the monitor. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE) and the antisaccadic eye movement test (ASEM). Measurements and Main Results: Preoperative baseline values of cerebral oxygen saturation (rSO 2) were 58.6% ± 10.2%. Patients with the nadir rSO 2 <35% had significantly higher incidences of postoperative ASEM and MMSE impairments than those with rSO 2 always above 35% (44% and 33% v 12% and 9%, respectively). Patients with areas of rSO 2 <40% for more than 10 minutes · % presented with a significantly higher incidence of postoperative ASEM and MMSE impairments than those with areas of rSO 2 <40% for less than 10 minutes · % (42% and 32% v 13% and 10%, respectively). Patients with postoperative ASEM or MMSE impairment had significantly lower nadir rSO 2 and significantly larger areas of rSO 2 <40%, <45%, and <50% than those with normal postoperative neuropsychological outcome. However, multivariate logistic regression analysis showed that areas of rSO 2 <40% were the only predictor for both postoperative ASEM and MMSE impairments. Conclusions: Intraoperative cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery with cardiopulmonary bypass. However, it remains to be determined whether interventions to maintain adequate cerebral oxygenation may improve neuropsychological outcome.]]></description><identifier>ISSN: 1053-0770</identifier><identifier>EISSN: 1532-8422</identifier><identifier>DOI: 10.1053/j.jvca.2004.07.007</identifier><identifier>PMID: 15578464</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Brain - blood supply ; cardiac surgery ; Cardiac Surgical Procedures - adverse effects ; Cardiopulmonary Bypass - adverse effects ; cerebral oxygen saturation ; Cognition Disorders - diagnosis ; Cognition Disorders - etiology ; Female ; Humans ; Male ; Monitoring, Intraoperative - methods ; Neurologic Examination - methods ; neuropsychological outcome ; Neuropsychological Tests ; Oxygen - blood ; Oxygen - metabolism ; Postoperative Complications - diagnosis ; Predictive Value of Tests ; Prospective Studies ; Time Factors</subject><ispartof>Journal of cardiothoracic and vascular anesthesia, 2004-10, Vol.18 (5), p.552-558</ispartof><rights>2004 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-2b54899b4fa92dd0d7cfc76e4f4f9ed49fbdf4ecbb6375a72632a3de3749ce5f3</citedby><cites>FETCH-LOGICAL-c352t-2b54899b4fa92dd0d7cfc76e4f4f9ed49fbdf4ecbb6375a72632a3de3749ce5f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15578464$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yao, Fun-Sun F.</creatorcontrib><creatorcontrib>Tseng, Chia-Chih A.</creatorcontrib><creatorcontrib>Ho, Chee-Yueh A.</creatorcontrib><creatorcontrib>Levin, Serle K.</creatorcontrib><creatorcontrib>Illner, Pavel</creatorcontrib><title>Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery</title><title>Journal of cardiothoracic and vascular anesthesia</title><addtitle>J Cardiothorac Vasc Anesth</addtitle><description><![CDATA[Objective: To evaluate the relationship between cerebral oxygen saturation and neuropsychological dysfunction after cardiac surgery. Design: Prospective and observational study. Setting: Operating room and cardiac floor of a university hospital. Participants: One hundred one patients undergoing elective cardiac surgery with cardiopulmonary bypass Intervention: Bilateral noninvasive cerebral oxygen saturations were monitored over the forehead. The anesthetic and surgical techniques were performed as usual, and no interventions were attempted based on the monitor. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE) and the antisaccadic eye movement test (ASEM). Measurements and Main Results: Preoperative baseline values of cerebral oxygen saturation (rSO 2) were 58.6% ± 10.2%. Patients with the nadir rSO 2 <35% had significantly higher incidences of postoperative ASEM and MMSE impairments than those with rSO 2 always above 35% (44% and 33% v 12% and 9%, respectively). Patients with areas of rSO 2 <40% for more than 10 minutes · % presented with a significantly higher incidence of postoperative ASEM and MMSE impairments than those with areas of rSO 2 <40% for less than 10 minutes · % (42% and 32% v 13% and 10%, respectively). Patients with postoperative ASEM or MMSE impairment had significantly lower nadir rSO 2 and significantly larger areas of rSO 2 <40%, <45%, and <50% than those with normal postoperative neuropsychological outcome. However, multivariate logistic regression analysis showed that areas of rSO 2 <40% were the only predictor for both postoperative ASEM and MMSE impairments. Conclusions: Intraoperative cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery with cardiopulmonary bypass. However, it remains to be determined whether interventions to maintain adequate cerebral oxygenation may improve neuropsychological outcome.]]></description><subject>Aged</subject><subject>Brain - blood supply</subject><subject>cardiac surgery</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiopulmonary Bypass - adverse effects</subject><subject>cerebral oxygen saturation</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - etiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Monitoring, Intraoperative - methods</subject><subject>Neurologic Examination - methods</subject><subject>neuropsychological outcome</subject><subject>Neuropsychological Tests</subject><subject>Oxygen - blood</subject><subject>Oxygen - metabolism</subject><subject>Postoperative Complications - diagnosis</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Time Factors</subject><issn>1053-0770</issn><issn>1532-8422</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u3CAURlHVqEmTvEAXFavu7GAMZix1U436EylSN-kaYbg4jDzgAp7Wj9C3LtaM1F1X9y7OPdL9PoTeNaRuCG8fDvXhpFVNCWE1ETUh4hW6aXhLqx2j9HXZC1URIcg1epvSgZCm4Vy8Qdfb2LGO3aA_e4gwRDXh8HsdwWMDSeUlquyCxy5hlVLQTmUw-JfLLxhUnFY8h5TDDBt2AuxhiWFOq34JUxidLjazJrt4fbZ4PBcQfE548QbiGJwfsVbROKVxWuIIcb1DV1ZNCe4v8xb9-PL5ef-tevr-9XH_6anSLae5ogNnu74fmFU9NYYYoa0WHTDLbA-G9XYwloEehq4VXAnatVS1BlrBeg3ctrfow9k7x_BzgZTl0SUN06Q8hCXJTjScCLYrID2DOoaUIlg5R3dUcZUNkVu08iC3AuRWgCRClgLK0fuLfRmOYP6dXBIvwMczAOXHk4Moky7RaDAugs7SBPc__18BVZ1H</recordid><startdate>20041001</startdate><enddate>20041001</enddate><creator>Yao, Fun-Sun F.</creator><creator>Tseng, Chia-Chih A.</creator><creator>Ho, Chee-Yueh A.</creator><creator>Levin, Serle K.</creator><creator>Illner, Pavel</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20041001</creationdate><title>Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery</title><author>Yao, Fun-Sun F. ; Tseng, Chia-Chih A. ; Ho, Chee-Yueh A. ; Levin, Serle K. ; Illner, Pavel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-2b54899b4fa92dd0d7cfc76e4f4f9ed49fbdf4ecbb6375a72632a3de3749ce5f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Brain - blood supply</topic><topic>cardiac surgery</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiopulmonary Bypass - adverse effects</topic><topic>cerebral oxygen saturation</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - etiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Monitoring, Intraoperative - methods</topic><topic>Neurologic Examination - methods</topic><topic>neuropsychological outcome</topic><topic>Neuropsychological Tests</topic><topic>Oxygen - blood</topic><topic>Oxygen - metabolism</topic><topic>Postoperative Complications - diagnosis</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yao, Fun-Sun F.</creatorcontrib><creatorcontrib>Tseng, Chia-Chih A.</creatorcontrib><creatorcontrib>Ho, Chee-Yueh A.</creatorcontrib><creatorcontrib>Levin, Serle K.</creatorcontrib><creatorcontrib>Illner, Pavel</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yao, Fun-Sun F.</au><au>Tseng, Chia-Chih A.</au><au>Ho, Chee-Yueh A.</au><au>Levin, Serle K.</au><au>Illner, Pavel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery</atitle><jtitle>Journal of cardiothoracic and vascular anesthesia</jtitle><addtitle>J Cardiothorac Vasc Anesth</addtitle><date>2004-10-01</date><risdate>2004</risdate><volume>18</volume><issue>5</issue><spage>552</spage><epage>558</epage><pages>552-558</pages><issn>1053-0770</issn><eissn>1532-8422</eissn><abstract><![CDATA[Objective: To evaluate the relationship between cerebral oxygen saturation and neuropsychological dysfunction after cardiac surgery. Design: Prospective and observational study. Setting: Operating room and cardiac floor of a university hospital. Participants: One hundred one patients undergoing elective cardiac surgery with cardiopulmonary bypass Intervention: Bilateral noninvasive cerebral oxygen saturations were monitored over the forehead. The anesthetic and surgical techniques were performed as usual, and no interventions were attempted based on the monitor. Neuropsychological outcome was assessed by the Mini-Mental State Examination (MMSE) and the antisaccadic eye movement test (ASEM). Measurements and Main Results: Preoperative baseline values of cerebral oxygen saturation (rSO 2) were 58.6% ± 10.2%. Patients with the nadir rSO 2 <35% had significantly higher incidences of postoperative ASEM and MMSE impairments than those with rSO 2 always above 35% (44% and 33% v 12% and 9%, respectively). Patients with areas of rSO 2 <40% for more than 10 minutes · % presented with a significantly higher incidence of postoperative ASEM and MMSE impairments than those with areas of rSO 2 <40% for less than 10 minutes · % (42% and 32% v 13% and 10%, respectively). Patients with postoperative ASEM or MMSE impairment had significantly lower nadir rSO 2 and significantly larger areas of rSO 2 <40%, <45%, and <50% than those with normal postoperative neuropsychological outcome. However, multivariate logistic regression analysis showed that areas of rSO 2 <40% were the only predictor for both postoperative ASEM and MMSE impairments. Conclusions: Intraoperative cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery with cardiopulmonary bypass. However, it remains to be determined whether interventions to maintain adequate cerebral oxygenation may improve neuropsychological outcome.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>15578464</pmid><doi>10.1053/j.jvca.2004.07.007</doi><tpages>7</tpages></addata></record>
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subjects Aged
Brain - blood supply
cardiac surgery
Cardiac Surgical Procedures - adverse effects
Cardiopulmonary Bypass - adverse effects
cerebral oxygen saturation
Cognition Disorders - diagnosis
Cognition Disorders - etiology
Female
Humans
Male
Monitoring, Intraoperative - methods
Neurologic Examination - methods
neuropsychological outcome
Neuropsychological Tests
Oxygen - blood
Oxygen - metabolism
Postoperative Complications - diagnosis
Predictive Value of Tests
Prospective Studies
Time Factors
title Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery
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