Soenarto Ratna Farida, Hidayat Jefferson Kasan, Eureka Oryza, Auerkari Aino Nindya
Department of Anesthesiology and Intensive Care, Universitas Indonesia, Jakarta, Indonesia.
J Pak Med Assoc. 2021 Feb;71(Suppl 2)(2):S10-S13.
This study aimed to evaluate the relationship between Post-operative Cognitive Dysfunction (POCD) and regional Oxygen saturation (rSOs) determined by NIRS monitoring during Open-heart surgery.
This was a prospective cohort study of all patients about to undergo Open-heart surgery at Cipto Mangunkusumo National Referral Hospital, Jakarta. Subjects who fulfilled the selection criteria underwent cognitive assessment one day before the surgery. Basal rSO2 was registered prior to anaesthetic induction, and this value was reported every 10 minutes throughout the procedure as the lowest rSO2 and total desaturation (drop >20%) duration. On postoperative day 5, cognitive function was reassessed. We declared a drop in the cognitive function if the score dropped to >20% from the baseline in at least two cognitive tests.
The incidence of POCD was 51.7%. Basal rSO2 values between POCD and non-POCD subjects were relatively similar. A significant difference was noted in the duration of total rSO2 desaturation between the two groups. Total rSO2 desaturation was longer in subjects with than without POCD. The ROC (receiver operating characteristic) curve showed a cut-off point of 20.5 minutes, with an AUC (area under curve) size of 126.5 minutes %.
Absolute rSO2 values did not correlate with POCD. However, a drop in rSO2 value >20% from baseline may correlate with POCD. The use of NIRS in Open-heart surgery may, be beneficial for POCD prevention.
本研究旨在评估心脏直视手术期间通过近红外光谱（NIRS）监测测定的术后认知功能障碍（POCD）与局部氧饱和度（rSOs）之间的关系。
这是一项对雅加达Cipto Mangunkusumo国家转诊医院所有即将接受心脏直视手术患者的前瞻性队列研究。符合入选标准的受试者在手术前一天接受认知评估。在麻醉诱导前记录基础rSO2，并在整个手术过程中每10分钟报告一次该值，作为最低rSO2和总去饱和（下降>20%）持续时间。在术后第5天，重新评估认知功能。如果在至少两项认知测试中分数从基线下降至>20%，我们判定为认知功能下降。
POCD的发生率为51.7%。POCD组和非POCD组受试者的基础rSO2值相对相似。两组之间在总rSO2去饱和持续时间上存在显著差异。有POCD的受试者的总rSO2去饱和时间比没有POCD的受试者更长。ROC（受试者工作特征）曲线显示截止点为20.5分钟，曲线下面积（AUC）大小为126.5分钟%。
rSO2的绝对值与POCD无关。然而，rSO2值较基线下降>20%可能与POCD相关。在心脏直视手术中使用NIRS可能有助于预防POCD。
