Department of Anesthesiology and Postoperative Intensive Care, University of Ioannina - School of Medicine, Ioannina, Greece.
Minerva Anestesiol. 2010 Mar;76(3):232-5. Epub 2009 Nov 30.
The authors describe the case of an elderly diabetic patient with a hip fracture who developed neurocognitive dysfunction and dysarthria preoperatively. Upon arrival in the operating room, the monitoring of cerebral oxygenation by near-infrared spectroscopy (NIRS) showed cerebral desaturation (44% on the left hemisphere and 46% on the right). Cerebral oximetry values were stabilized during the surgery after administration of crystalloid fluids and vasoconstrictive drugs and were ameliorated significantly after administration of two units of blood. The patient's cerebral saturation was 60% on the left and 58% on the right hemisphere after the end of surgery and he was in normal neurological status. Observations underlined the importance of preoperative evaluation of cerebral tissue oxygenation by non-invasive cerebral NIRS in elderly diabetic patients who develop hypovolemia and anemia due to major fracture.
作者描述了一例老年糖尿病髋部骨折患者，该患者术前出现神经认知功能障碍和构音障碍。患者进入手术室后，近红外光谱（NIRS）监测脑氧合显示脑饱和度降低（左侧 44%，右侧 46%）。给予晶体液和血管收缩药物后，手术过程中脑氧饱和度值得以稳定，并在输注 2 单位血液后显著改善。术后患者左侧脑饱和度为 60%，右侧为 58%，神经状态正常。该研究强调了对因大骨折导致血容量减少和贫血的老年糖尿病患者，术前通过非侵入性脑 NIRS 评估脑组织氧合的重要性。
