Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

Abstract

Background:The current study was designed to determine the relation between preoperative cerebral oxygen saturation (ScO 2 ), variables of cardiopulmonary function, mortality, and morbidity in a heterogeneous cohort of cardiac surgery patients. Methods: In this study, 1,178 consecutive patients scheduled for on-pump surgery were prospectively studied. Preoperative ScO 2 , demographics, N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T, clinical outcomes, and 30-day and 1-yr mortality were recorded. Results: Median additive EuroSCORE was 5 (range: 0 -19).Thirty-day and 1-yr mortality and major morbidity (at least two major complications and/or a high-dependency unit stay of at least 10 days) were 3.5%, 7.7%, and 13.3%, respectively. Median minimal preoperative oxygen supplemented ScO 2 (ScO 2min-ox ) was 64% (range: 15-92%). ScO 2min-ox was correlated (all: P value Ͻ0.0001) with N-terminal pro-Btype natriuretic peptide (: Ϫ0.35), high-sensitive troponin T (: Ϫ0.28), hematocrit (: 0.34), glomerular filtration rate

A pilot study of cerebral tissue oxygenation and postoperative cognitive dysfunction among patients undergoing coronary artery bypass grafting randomised to surgery with or without cardiopulmonary bypass*

“…There were no significant differences in any of these parameters between the two groups of patients. Median (IQR [range]) length of stay in ICU and in hospital was 1 (1-1 [1][2][3][4][5][6][7][8][9][10][11][12]) and 9 (6-12 ) days, respectively, in the CPB group, and 1 (1-1 [1][2][3][4][5][6][7][8]) and 8 (6-11 [4][5][6][7][8][9][10][11][12][13][14][15]) days for patients in the no-CPB group (p = 0.840 and p = 0.552, respectively).…”

“…It gives an indication of the balance between oxygen delivery and oxygen consumption, which may have prognostic value. A recent study showed that pre-operative cerebral oximetry values predicted various postoperative outcomes after coronary surgery using CPB [12]. Other studies have shown a correlation between the severity and duration of cerebral desaturation, with or without CPB, and subsequent postoperative cognitive dysfunction [13,14], although the evidence is somewhat weak [15].…”

Tissue oximetry in anaesthesia and intensive care

“…Its low value has been observed to correlate with a high risk of surgery according to the EuroSCORE as well as poor diastolic and systolic functions of the left ventricle and to indicate an increased risk of postoperative delirium [17,18]. Heringlake and co-workers [19] have demonstrated the lowest value of brain saturation immediately prior to cardiac surgery, i.e. below 50%, is associated with increased 30-day and annual mortality.…”

Cerebral Oxygen Monitoring: An Observational Prospective Study on Seated Position Neurosurgical Procedures

“…Maintenance of rSO2 within 10% to 20% of baseline in these patient groups reduced complications (4,5). Although the normal rSO2 in a fit young patient may be around 60% to 70%, representing a venous weighted measure of cerebral tissue oxygenation, values as low as 35% are sometimes seen in elderly patients presented for surgery and may be a significant predictor of poor outcome (6). A recent study suggests that rSO2 is a potentially important biomarker that should be measured in heart failure patients and suggests that it may be a useful marker of target organ perfusion (7).…”