Slater Tammy, Stanik-Hutt Julie, Davidson Patricia
a Adult/Gerontology - Acute Care Nurse Practitioner Program, School of Nursing , Johns Hopkins University , 525 N. Wolfe Street, Baltimore , 21205 , MD , USA.
b Adult/Gerontology - Acute Care Nurse Practitioner Track, College of Nursing , University of Iowa , 101 College of Nursing Building, 50 Newton Road, Iowa City , IA 52242 , USA.
Contemp Nurse. 2017 Dec;53(6):669-680. doi: 10.1080/10376178.2017.1422392. Epub 2018 Jan 17.
Following adult cardiac surgery, often difficult to detect fluctuations in regional cerebral perfusion can contribute to strokes. Optimal cerebral perfusion remains elusive and traditional monitoring strategies do not consistently identify acute changes. Non-invasive cerebral oximetry may detect perfusion variations.
To assess the feasibility of postoperative non-invasive cerebral oximetry monitoring.
Non-invasive cerebral oximetry was performed on adult aortic valve surgery patients in a cardiac surgical intensive care unit. Monitoring feasibility was assessed using an investigator-developed, data extraction tool.
Non-invasive cerebral oximetry was completed in 94% of patients. Sixty percent had values that fell below pre-set ischemic threshold. Nurses reported monitoring was feasible, and they perceived identifying deleterious cerebral perfusion trends may improve patient care.
Prevalence of low cerebral oximetry values underscores the importance of increasing sensitivity of monitoring tools. Further evaluation is required to assess this modality and the role of nurses in optimizing neurocognitive outcomes. Impact statement: Cerebral oximetry monitoring may help identify adult patients at risk of neurological complications after cardiac surgery, and as a consequence initiate definitive therapeutic strategies.
成人心脏手术后，往往难以检测到局部脑灌注的波动，这可能导致中风。最佳脑灌注仍难以捉摸，传统的监测策略并不能始终识别急性变化。无创脑血氧饱和度测定法可能检测到灌注变化。
评估术后无创脑血氧饱和度测定监测的可行性。
在心脏外科重症监护病房对接受成人主动脉瓣手术的患者进行无创脑血氧饱和度测定。使用研究人员开发的数据提取工具评估监测的可行性。
94%的患者完成了无创脑血氧饱和度测定。60%的患者的值低于预先设定的缺血阈值。护士报告监测是可行的，他们认为识别有害的脑灌注趋势可能会改善患者护理。
低脑血氧饱和度值的普遍性凸显了提高监测工具灵敏度的重要性。需要进一步评估这种方式以及护士在优化神经认知结果中的作用。影响声明：脑血氧饱和度监测可能有助于识别心脏手术后有神经并发症风险的成年患者，从而启动明确的治疗策略。
