Vranken Nousjka P A, Weerwind Patrick W, Sutedja Nadia A, Ševerdija Ervin E, Barenbrug Paul J C, Maessen Jos G
Departments of Cardiothoracic Surgery; and.
Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands.
J Extra Corpor Technol. 2017 Sep;49(3):182-191.
Postoperative neurological complications (PNCs) following cardiac surgery with cardiopulmonary bypass (CPB) is a detrimental complication, contributing to increased mortality rates and health care costs. To prevent intraoperative cerebral desaturations associated with PNC, continuous brain monitoring using near-infrared spectroscopy has been advocated. However, clear evidence for a defined desaturation threshold requiring intervention during CPB is still lacking. Since cerebral oximetry readings are nonspecific, cerebral tissue oxygenation values need to be interpreted with caution and in the context of all available clinical information. Therefore, maintaining an intact autoregulatory activity during CPB rather than solely focusing on regional cerebral oxygen saturation measurements will collectively contribute to optimization of patient care during CPB.
体外循环心脏手术后的术后神经并发症（PNCs）是一种有害的并发症，会导致死亡率上升和医疗成本增加。为预防与PNCs相关的术中脑氧饱和度降低，有人主张使用近红外光谱进行连续脑监测。然而，仍缺乏关于体外循环期间需要干预的明确氧饱和度降低阈值的明确证据。由于脑氧饱和度读数不具有特异性，因此需要谨慎解读脑组织氧合值，并结合所有可用的临床信息进行解读。因此，在体外循环期间维持完整的自动调节活动，而不是仅仅关注局部脑氧饱和度测量，将共同有助于优化体外循环期间的患者护理。
