Association between cognitive dysfunction after cardiac surgery under cardiopulmonary bypass and the intraoperative lowest level of regional cerebral oxygen saturation
Chang Xin
Guo Zhen
Shi dan
Xu Hua
Zou Liangjian
Abstract：Objective To investigate whether the lowest regional cerebral oxygen saturation (rScO2) value during cardiopulmonary bypass (CPB) was associated with postoperative cognitive dysfunction (POCD) and to evaluate the risk factors of POCD. Methods The rScO2 levels of 109 patients undergoing elective cardiac valve surgery were maintained during operation, with the baseline value greater than 80％ and the absolute value higher than 55％. The lowest value of rScO2 was recorded, together with the duration of CPB, aortic crossclamp time, the lowest hemoglobin value, red blood cell transfusion, postoperative mechanical ventilation time, postoperative ICU stay, postoperative hospital stay, CRRT treatment and major organ complications. Two tests of cognitive assessment were conducted the day before surgery and at the 4 th day after the surgery. POCD was diagnosed if the decrease of cognitive score after the surgery was greater than 4 in any item of the two tests. Results In the 88 patients who finished the whole test schedule, 25 (28.4％) developed POCD. The lowest rScO2 value during surgery was associated with POCD. The ability to perform the tests was impacted by educational level. Conclusion During cardiac surgery, the lowest rScO2 value was associated with POCD. However, further research was needed to confirm the optimal rScO2 safety range to reduce the incidence of POCD.
Keywords：Cardiopulmonary bypassCardiac surgeryPostoperative cognitive dysfunctionCerebral oxygen saturationCognitive function assessmentRisk factor
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 26-31,40 )