Jugular Venous Bulb Oxygen Saturation in Patients with Preexisting Diabetes Mellitus or Stroke during Normothermic Cardiopulmonary Bypass

Abstract

A reduced SjvO2 value was observed more frequently in patients with preexisting diabetes mellitus or stroke during normothermic cardiopulmonary bypass. It is possible that cerebral circulation during normothermic bypass is altered in patients with risk factors for cerebrovascular disorder.

Factors Associated with Postoperative Cognitive Dysfunction in Patients Undergoing Cardiac Surgery

“…8 One possible mechanism of the adverse cognitive outcome in patients with diabetes mellitus may be related to deficiencies in cerebral autoregulation during CPB. [15][16][17][18][19] However, the mechanisms underlying the relationship between age and postoperative neurocognitive decline remain unclear. Indeed, Newman et al 20 reported a correlation between impaired cerebral autoregulation and an increased age, and the present study demonstrated that a reduced SivO 2 level was not related to the long-term postoperative cognitive outcome in elderly patients.…”

Association between cerebrovascular carbon dioxide reactivity and postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus

“…The position of the jugular bulb catheter was verified by standard radiography, and the catheter was repositioned until correctly situated (catheter tip cranial to the line extending from the atlanto-occipital joint space and caudal to the lower margin of the orbit). SjvO 2 data were obtained and processed in a monitor-computer interface and displayed and stored every 5 s with an Apple computer (Apple Computer, Cupertino, CA, USA) [9].…”

“…Croughwell et al [6] reported that cerebral blood flow (CBF) in diabetic patients was constant despite an increase in temperature from 27°to 37°C, in contrast to an 83% CBF increase in nondiabetic patients during the rewarming period. In previous studies, we [7][8][9][10][11][12] and others [6] found that reduced jugular venous oxygen saturation (SjvO 2 below 50%: estimated by the balance of cerebral oxygen supply and demand), was closely associated with short-term cognitive dysfunction in elderly or diabetic patients. Moreover, we [9] and Croughwell et al [6] showed that diabetic patients more frequently experienced reduced SjvO 2 during CPB.…”

Preoperative depression is a risk factor for postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus

“…Hemodynamic data and arterial and jugular venous blood gases were measured at different times, as previously described in detail [14,15]. The presence or absence of carotid artery stenosis, defined as narrowing [50% [4], was confirmed by preoperative ultrasonography and MRI.…”