Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.
Ann Thorac Cardiovasc Surg. 2024 Jan 25;30(1). doi: 10.5761/atcs.oa.23-00057. Epub 2023 Jul 1.
To investigate the effect of optimizing regional cerebral oxygen saturation (rScO) on the incidence of postoperative delirium and surgical outcome in infants with congenital heart disease.
Sixty-one infants experienced desaturation in rScO of 10% from baseline for more than 30 seconds during surgery between January 2020 and January 2022. Among them, 32 cases (Group A) received the corresponding treatment in the process of desaturation and 29 cases (Group B) were observed without receiving any treatment. General information, cerebral oxygen saturation, the incidence of postoperative delirium, and other relevant clinical data were collected.
The duration and severity of intraoperative rScO desaturation in Group A were significantly lower than those in Group B. The incidence of postoperative delirium in Group A was significantly lower than that in Group B. There was no significant difference in the positive screening score for delirium between the two groups. Binary logistic regression analysis showed that the aortic cross-clamp time, mechanical ventilation duration, and severity of intraoperative rScO desaturation were significantly correlated with the occurrence of postoperative delirium.
Aggressive rScO desaturation treatment is associated with a lower incidence of postoperative delirium and improved surgical outcomes.
研究优化区域性脑氧饱和度（rScO）对先天性心脏病患儿术后谵妄发生率和手术结果的影响。
2020 年 1 月至 2022 年 1 月期间，在手术过程中，61 名婴儿的 rScO 从基线下降 10%并持续超过 30 秒。其中 32 例（A 组）在发生 rScO 下降时接受了相应的治疗，29 例（B 组）未接受任何治疗。收集一般资料、脑氧饱和度、术后谵妄发生率等相关临床资料。
A 组术中 rScO 下降的持续时间和严重程度明显低于 B 组。A 组术后谵妄发生率明显低于 B 组。两组术后谵妄阳性筛查评分无统计学差异。二项逻辑回归分析显示，主动脉阻断时间、机械通气时间和术中 rScO 下降严重程度与术后谵妄的发生显著相关。
积极的 rScO 下降治疗与术后谵妄发生率降低和手术结果改善相关。
