Baseline Regional Cerebral Oxygen Saturation Correlates With Left Ventricular Systolic and Diastolic Function

Paquet, Catherine; Deschamps, Alain; Denault, André; Couture, Pierre; Carrier, Michel; Babin, Denis; Lévesque, Sylvie; Piquette, Dominique; Lambert, Jean; Tardif, Jean‐Claude

doi:10.1053/j.jvca.2008.02.013

Cited by 51 publications

(36 citation statements)

References 28 publications

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“…25 Paquet et al observed that baseline ScO 2 was related to LVEF in patients undergoing cardiac surgery and that ScO 2 had an acceptable accuracy to identify left ventricular dysfunction in these patients. 26 The findings of the current study, showing significant correlations between NTproBNP, hsTNT, LVEF, and ScO 2 in a large patient sample, support the concept that ScO 2 is influenced by myocardial function and the performance of the cardiopulmonary system. This may have clinical and scientific implications.…”

Section: Discussionsupporting

confidence: 81%

Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

et al. 2011

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Background:The current study was designed to determine the relation between preoperative cerebral oxygen saturation (ScO 2 ), variables of cardiopulmonary function, mortality, and morbidity in a heterogeneous cohort of cardiac surgery patients. Methods: In this study, 1,178 consecutive patients scheduled for on-pump surgery were prospectively studied. Preoperative ScO 2 , demographics, N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T, clinical outcomes, and 30-day and 1-yr mortality were recorded. Results: Median additive EuroSCORE was 5 (range: 0 -19).Thirty-day and 1-yr mortality and major morbidity (at least two major complications and/or a high-dependency unit stay of at least 10 days) were 3.5%, 7.7%, and 13.3%, respectively. Median minimal preoperative oxygen supplemented ScO 2 (ScO 2min-ox ) was 64% (range: 15-92%). ScO 2min-ox was correlated (all: P value Ͻ0.0001) with N-terminal pro-Btype natriuretic peptide (: Ϫ0.35), high-sensitive troponin T (: Ϫ0.28), hematocrit (: 0.34), glomerular filtration rate

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Section: Discussionsupporting

confidence: 81%

Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

et al. 2011

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“…Monitoring ScO 2 and preventing CNS desaturation provides a unique opportunity for preventing "silent" but potentially dangerous ischemia of other organs and tissues. Cerebral oximetry measurements are conducted with a non-invasive technique, and, in view of the presented facts, it may be used to substitute the invasive continuous monitoring of mixed venous blood saturation [19]. It should be stressed that no synchronous correlation has been found between cerebral desaturation events and lowered arterial blood saturation measured with pulse oximetry [20].…”

Section: Discussionmentioning

confidence: 99%

Anaesthesiology and intensive care Does the optimization of intra-operative cerebral regional oxygen saturation have an effect on neurological function in elderly patients undergoing cardiac surgery?

Kucewicz¹,

Żegleń²,

Wojarski³

et al. 2013

kitp

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StreszczenieWstęp: W celu ograniczenia częstości występowania powikłań neurologicznych po operacjach kardiochirurgicznych podejmowane są różne działania. Należy do nich śródoperacyjne monitorowanie funkcji ośrodkowego układu nerwowego (OUN). Celem pracy była ocena wpływu utrzymywania regionalnej saturacji mózgowej w wyznaczonych granicach na częstość występowania powikłań neurologicznych typu I we wczesnym okresie pooperacyjnym u chorych w wieku ≥ 75 lat poddawanych zabiegom kardiochirurgicznym. Analizowano także czę-stość występowania innych powikłań w obu grupach. Materiał i metody: Do grupy badanej zakwalifikowano pacjentów operowanych w 2011 r., u których śródoperacyjnie monitorowano oksymetrię mózgową i utrzymywano jej wartość na optymalnym, indywidualnie wyznaczonym poziomie. Grupę kontrolną stanowili chorzy, u których zrezygnowano z monitorowania ScO 2 . Do badań włączono chorych ≥ 75. roku życia. Grupa badana liczyła 119, kontrolna 138 chorych. Do monitorowania ScO 2 wykorzystano metodę spektroskopii w widmie bliskim podczerwieni. Wyniki: Chorzy w grupie monitorowania ScO 2 byli znamiennie starsi i w tej grupie częściej odnotowano przebyty udar OUN. Mimo to wczesne udary pooperacyjne wystąpiły z tą samą czę-stością w obu grupach. Chorzy w grupie badanej charakteryzowali się w okresie pooperacyjnym krótszym czasem wentylacji płuc i mniejszą liczbą przetoczonych jednostek koncentratu krwinek czerwonych, mimo że w grupie kontrolnej więcej chorych sklasyfikowano w I grupie wydolności wg NYHA. Pacjenci Kardiochirurgia i Torakochirurgia Polska 2013; 10 (4) 380 ANAESTHESIOLOGY AND INTENSIVE CARE AbstractBackground: The optimization of cerebral oxygen delivery variables by using noninvasive cerebral oximetry could reduce the incidence of stroke. The aim of the study was to evaluate the effect of the intraoperative management of oxygen delivery on neurological function during the early postoperative period in elderly patients undergoing cardiac surgery. Material and methods: This observational study included 257 patients, aged 75 and above, who underwent surgery in 2011. In the study group (119 patients), cerebral oxygen saturation was monitored and managed in order to maintain the oximetry values within individually assigned optimal levels. The control group (138 patients) underwent cardiac surgery without the intraoperative monitoring of cerebral oximetry. The two groups were dissimilar with regard to age, EuroSCORE risk factors, previous cerebral vascular accidents, and chronic kidney disease. More patients in the control group had preoperative NYHA class I. Results: There was no difference between the groups with regard to the incidence of permanent stroke. Total ventilation time was significantly shorter in the study group. Patients in the study group required shorter lung ventilation and a lower number of packed red blood cell units. The length of postoperative ward and hospital stay was longer among the patients with low values of baseline cerebral oximetry (< 50%). Conclusions: These findings suggest that...

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“…Its low value has been observed to correlate with a high risk of surgery according to the EuroSCORE as well as poor diastolic and systolic functions of the left ventricle and to indicate an increased risk of postoperative delirium [17,18]. Heringlake and co-workers [19] have demonstrated the lowest value of brain saturation immediately prior to cardiac surgery, i.e.…”

Section: Use Of Brain Oximetry During Cardiac Surgerymentioning

confidence: 99%

Tissue oximetry in anaesthesia and intensive care

Biedrzycka¹,

Lango²

2016

Anaesthesiol Intensive Ther

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Conventional monitoring during surgery and intensive care is not sufficiently sensitive to detect acute changes in vital organs perfusion, while its good quality is critical for maintaining their function. Disturbed vital organ perfusion may lead to the development of postoperative complications, including neurological sequel and renal failure. Nearinfra-red spectroscopy (NIRS) represents one of up-to-date techniques of patient monitoring which is commonly used for the assessment of brain oximetry in thoracic aorta surgery, and -increasingly more often -in open-heart surgery. Algorithms for maintaining adequate brain saturation may result in a decrease of neurological complications and cognitive dysfunction following cardiac surgery. The assessment of kidney and visceral perfusion with tissue oximetry is gaining increasing interest during pediatric cardiac surgery. Attempts at decreasing complications by the use of brain oximetry during carotid endarterectomy, as well as thoracic and abdominal surgery demonstrated conflicting results. In recent years NIRS technique was proposed as a tool for muscle perfusion assessment under short term ischemia and reperfusion, referred to as vascular occlusion test (VOT). This monitoring extension allows for the identification of early disturbances in tissue perfusion. Results of recent studies utilizing VOT suggest that the muscle saturation decrease rate is reduced in septic shock patients, while decreased speed of saturation recovery on reperfusion is related to disturbed microcirculation. Being non-invasive and feasible technique, NIRS offers an improvement of preoperative risk assessment in cardiac surgery and promises more comprehensive intraoperative and ICU patient monitoring allowing for better outcome.

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Baseline Regional Cerebral Oxygen Saturation Correlates With Left Ventricular Systolic and Diastolic Function

Cited by 51 publications

References 28 publications

Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

Anaesthesiology and intensive care Does the optimization of intra-operative cerebral regional oxygen saturation have an effect on neurological function in elderly patients undergoing cardiac surgery?

Tissue oximetry in anaesthesia and intensive care

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