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Is baseline cerebral oximetry a better predictor than carotid scan for postoperative delirium in cardiac surgery?

作者信息

Khazi Fayaz Mohammed, Al-Safadi Faouzi, Al Asaad Mohannad M R, Aljassim Obaid

机构信息

Department of Cardiothoracic Surgery, Dubai Hospital, Al Baraha, Dubai, United Arab Emirates.

出版信息

J Saudi Heart Assoc. 2018 Jul;30(3):260-263. doi: 10.1016/j.jsha.2017.10.003. Epub 2017 Nov 4.

DOI:10.1016/j.jsha.2017.10.003
PMID:29983501
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6026401/
Abstract

Guidelines recommend screening patients for carotid-artery stenosis, but unfortunately, measurement of baseline cerebral oximetry levels is still not a routine practice prior to cardiac surgery. We report a 41-year-old woman who presented with a normal carotid scan and unexpectedly low baseline cerebral oximetry levels. She had delayed postoperative recovery and discharge from hospital following her coronary-artery bypass surgery. This case report reiterates the prognostic significance of cerebral oximetry in the preoperative checkup and the association of low intraoperative values to postoperative cerebral impairment. It can also be identified as a comparatively better tool for preventing cognitive disturbances after cardiac surgery.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9c8/6026401/e8d273453d8b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9c8/6026401/e8d273453d8b/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9c8/6026401/e8d273453d8b/gr1.jpg

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本文引用的文献

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J Vasc Surg. 2016 Mar;63(3):710-4. doi: 10.1016/j.jvs.2015.10.008.
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Cerebral oxygenation monitoring in patients with bilateral carotid stenosis undergoing urgent cardiac surgery: Observational case series.双侧颈动脉狭窄患者行急诊心脏手术时的脑氧监测：观察性病例系列
Ann Card Anaesth. 2016 Jan-Mar;19(1):59-62. doi: 10.4103/0971-9784.173021.
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Preoperative cerebral oxygen saturation and clinical outcomes in cardiac surgery.
心脏手术患者术前脑氧饱和度与临床转归。
Anesthesiology. 2011 Jan;114(1):58-69. doi: 10.1097/ALN.0b013e3181fef34e.
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Neuroprotective properties of levosimendan in an in vitro model of traumatic brain injury.左西孟旦在体外创伤性脑损伤模型中的神经保护作用。
BMC Neurol. 2010 Oct 21;10:97. doi: 10.1186/1471-2377-10-97.
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The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery.老年冠状动脉旁路移植术后患者脑氧饱和度变化与术后认知功能障碍的关系。
J Cardiothorac Vasc Anesth. 2011 Feb;25(1):95-104. doi: 10.1053/j.jvca.2010.03.019. Epub 2010 Jul 22.
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A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy.一种用于术中脑近红外光谱技术的拟议算法。
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Monitoring level of sedation with bispectral EEG analysis: comparison between hypothermic and normothermic cardiopulmonary bypass.使用脑电双频分析监测镇静水平：低温与常温体外循环的比较
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