Harilall Yakeen, Adam Jamila K, Biccard Bruce M, Reddi Anu
Dept of Cardiothoracic Surgery, Inkosi Albert Luthuli Central Hospital, KZN, South Africa.
Perfusion. 2011 Mar;26(2):83-90. doi: 10.1177/0267659110387846. Epub 2010 Nov 15.
We compared simultaneous regional cerebral oxygen saturation and central venous oxygen saturation at different time periods in 20 adult patients (median age, 57.9; range, 35 to 76 years) undergoing off-pump coronary artery bypass (OPCAB) graft surgery (n= 20). Mean arterial pressure (MAP), partial pressure of carbon dioxide (PcvCO(2)), heart rate, haematocrit (Hct), lactate and patient oxygen saturation (SpO(2)) were also recorded as a secondary analysis to determine independent predictors of cerebral desaturation and interactions between predictors. The cross-sectional analysis performed at each time point showed several significant moderate to strong positive correlations between central venous oxygen saturation and both right and left cerebral oxygen saturations; however, right cerebral saturations correlated better with central venous saturations than left cerebral saturation. Partial pressure of carbon dioxide (PcvCO(2)) was identified as a major predictor of cerebral saturation 0.59 (p < 0.001). Central venous saturation can be used as a surrogate measure of cerebral oxygen saturation during OPCAB surgery.
我们比较了20例接受非体外循环冠状动脉搭桥术（OPCAB）的成年患者（年龄中位数为57.9岁；范围为35至76岁）在不同时间段的同步局部脑氧饱和度和中心静脉氧饱和度（n = 20）。作为次要分析，还记录了平均动脉压（MAP）、二氧化碳分压（PcvCO₂）、心率、血细胞比容（Hct）、乳酸和患者氧饱和度（SpO₂），以确定脑去饱和的独立预测因素以及预测因素之间的相互作用。在每个时间点进行的横断面分析显示，中心静脉氧饱和度与左右脑氧饱和度之间存在若干显著的中度至强正相关；然而，右脑饱和度与中心静脉饱和度的相关性优于左脑饱和度。二氧化碳分压（PcvCO₂）被确定为脑饱和度的主要预测因素，为0.59（p < 0.001）。在OPCAB手术期间，中心静脉饱和度可作为脑氧饱和度的替代指标。
