Matsukawa Shino, Hamada Miho, Mizota Toshiyuki
Department of Anesthesia, Kyoto University Hospital, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507 Japan.
JA Clin Rep. 2017;3(1):13. doi: 10.1186/s40981-017-0084-7. Epub 2017 Apr 8.
Regional cerebral oxygen saturation (rSO) monitoring by near-infrared spectroscopy provides valuable information regarding cerebral oxygen delivery, and it has been increasingly used in cardiovascular surgery. Although it has been shown that dialysis-dependent patients [hemodialysis (HD) patients] suffer from low cerebral perfusion, limited information is available on cerebral tissue oxygenation levels in HD patients.
In this retrospective study, the preoperative rSO values in 9 HD patients undergoing coronary artery bypass graft surgery were compared with those in 40 non-HD patients. HD patients had lower preoperative rSO values than non-HD patients (median: 46 vs. 68%, respectively, < 0.001). Despite adjusting for age, hemoglobin concentration, and left ventricular ejection fraction using multivariable linear regression, HD showed a strong association with low rSO (estimated coefficient: -20.4, < 0.001).
HD showed a strong association with low preoperative rSO values in patients undergoing coronary artery bypass graft surgery, even after adjusting for known factors that affect rSO values, including age, hemoglobin concentration, and cardiac systolic function. Further research is required to elucidate the mechanisms decreasing rSO values in HD patients.
通过近红外光谱法监测局部脑氧饱和度（rSO）可提供有关脑氧输送的有价值信息，并且它在心血管手术中的应用越来越广泛。尽管已经表明依赖透析的患者[血液透析（HD）患者]存在脑灌注不足的情况，但关于HD患者脑组织氧合水平的信息有限。
在这项回顾性研究中，将9例接受冠状动脉旁路移植手术的HD患者的术前rSO值与40例非HD患者的术前rSO值进行了比较。HD患者术前rSO值低于非HD患者（中位数分别为46%和68%，<0.001）。尽管使用多变量线性回归对年龄、血红蛋白浓度和左心室射血分数进行了校正，但HD与低rSO仍有很强的相关性（估计系数：-20.4，<0.001）。
在接受冠状动脉旁路移植手术的患者中，即使在对影响rSO值的已知因素（包括年龄、血红蛋白浓度和心脏收缩功能）进行校正后，HD与术前低rSO值仍有很强的相关性。需要进一步研究以阐明HD患者rSO值降低的机制。
