Reduced cerebral oxygen saturation during thoracic surgery predicts early postoperative cognitive dysfunction

Tang, Li-Yu; Kazan, Roy; Taddei, Riccardo; Zaouter, Cédrick; Cyr, Stéphane; Hemmerling, Thomas M.

doi:10.1093/bja/aer501

Cited by 119 publications

(75 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…13 In addition, previous studies have shown that intraoperative regional cerebral desaturation is associated with lower postoperative MMSE scores in lung surgery patients. 12,28 Therefore, cerebral desaturation is considered a likely causative factor for POCD. A previous report 13 showed that cerebral desaturation was related to choice of anesthetic in OLV.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial

Egawa

Inoue

Nishiwada

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] A previous study reported that cerebral oxygen saturation was higher in the sevoflurane anesthesia group than in the propofol anesthesia group during lung surgery. 13 Alternatively, a recent review found little evidence for differences in outcomes between inhalation and intravenous anesthesia during lung surgery.…”

Section: Résumémentioning

confidence: 98%

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial

Egawa

Inoue

Nishiwada

et al. 2016

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…Several recent studies have suggested that poorer intraoperative hemodynamic function may be associated with adverse neurocognitive outcomes among patients undergoing surgical procedures requiring single-lung ventilation (10,11). Tang and colleagues (10) demonstrated that reduced cerebral oxygen saturation predicted early cognitive dysfunction as determined by using the Mini Mental State Examination in a sample of 76 surgical patients. Similarly, Suehiro and Okutai (11) found that longer duration of cerebral desaturation was associated with greater impairment in cognitive function following pulmonary lobectomy.…”

mentioning

confidence: 99%

Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium

et al. 2016

View full text Add to dashboard Cite

Rationale: Delirium is common following lung transplant and is associated with poorer clinical outcomes. The extent to which intraoperative hemodynamic alterations may contribute to postoperative delirium among lung transplant recipients has not been examined. Objectives:To examine the impact of intraoperative hemodynamic changes on neurobehavioral outcomes among lung transplant recipients.Methods: Intraoperative hemodynamic function during lung transplant was assessed in a consecutive series of patients between March and November 2013. Intraoperative cerebral perfusion pressure was assessed every minute in all patients. Following lung transplant, patients were monitored for the presence and severity of delirium using the Confusion Assessment Method and the Delirium Rating Scale until hospital discharge.Measurements and Main Results: Sixty-three patients received lung transplants, of whom 23 (37%) subsequently developed delirium. Lower cerebral perfusion pressure was associated with increased risk of delirium (odds ratio [OR], 2.08 per 10-mm Hg decrease; 95% confidence interval [CI], 1.02-4.24; P = 0.043), longer duration of delirium (OR, 1.7 d longer per 10-mm Hg decrease; 95% CI, 1.1-2.7; P = 0.022), and greater delirium severity (b = 20.81; 95% CI, 21.47 to 20.15; P = 0.017).Conclusions: Poorer cerebral perfusion pressure during lung transplant is associated with greater risk for delirium following transplant, as well as greater duration and severity of delirium, independent of demographic and medical predictors. Author Contributions: Concept and design, J.A.B., S.K.R., R.D.D., S.M.P., J.P.M., and P.J.S. Data collection, P.J.S., J.P.M., B.M.H., and S.K.R. Analysis and interpretation of the data, P.J.S., J.P.M., and J.A.B. Drafting of the manuscript, P.J.S., J.P.M., S.M.P., and J.A.B. Critical revision of the article for important intellectual content, P

show abstract

“…The maintenance of slowed down saturation increases after 24 hours of treatment is associated with poorer prognosis [39]. Furthermore, tissue saturation in septic shock is found to increase significantly quicker in survivors compared to non-survivors [29,43].…”

Section: Use Of Oximetry For Evaluation Of Microcirculation and Oxygementioning

confidence: 99%

“…Tang and colleagues [29] have observed a relationship between low values of brain saturation and cognitive dysfunctions in the early postoperative period following the procedures with onelung ventilation. Moreover, patients with a decrease in brain saturation by at least 25% were hospitalized substantially longer [30].…”

Section: Use Of Brain Oximetry In Other Surgical Fieldsmentioning

confidence: 99%

Tissue oximetry in anaesthesia and intensive care

Biedrzycka¹,

Lango²

2016

Anaesthesiol Intensive Ther

View full text Add to dashboard Cite

Conventional monitoring during surgery and intensive care is not sufficiently sensitive to detect acute changes in vital organs perfusion, while its good quality is critical for maintaining their function. Disturbed vital organ perfusion may lead to the development of postoperative complications, including neurological sequel and renal failure. Nearinfra-red spectroscopy (NIRS) represents one of up-to-date techniques of patient monitoring which is commonly used for the assessment of brain oximetry in thoracic aorta surgery, and -increasingly more often -in open-heart surgery. Algorithms for maintaining adequate brain saturation may result in a decrease of neurological complications and cognitive dysfunction following cardiac surgery. The assessment of kidney and visceral perfusion with tissue oximetry is gaining increasing interest during pediatric cardiac surgery. Attempts at decreasing complications by the use of brain oximetry during carotid endarterectomy, as well as thoracic and abdominal surgery demonstrated conflicting results. In recent years NIRS technique was proposed as a tool for muscle perfusion assessment under short term ischemia and reperfusion, referred to as vascular occlusion test (VOT). This monitoring extension allows for the identification of early disturbances in tissue perfusion. Results of recent studies utilizing VOT suggest that the muscle saturation decrease rate is reduced in septic shock patients, while decreased speed of saturation recovery on reperfusion is related to disturbed microcirculation. Being non-invasive and feasible technique, NIRS offers an improvement of preoperative risk assessment in cardiac surgery and promises more comprehensive intraoperative and ICU patient monitoring allowing for better outcome.

show abstract

Reduced cerebral oxygen saturation during thoracic surgery predicts early postoperative cognitive dysfunction

Abstract: Early cognitive dysfunction after thoracic surgery with SLV is positively related to intraoperative decline of S(ct)O(2).

Cited by 119 publications

References 23 publications

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial

Reduced Cerebral Perfusion Pressure during Lung Transplant Surgery Is Associated with Risk, Duration, and Severity of Postoperative Delirium

Tissue oximetry in anaesthesia and intensive care

Contact Info

Product

Resources

About