Prolonged postoperative cerebral oxygen desaturation after cardiac surgery: A prospective observational study
BACKGROUND
Near-infrared spectroscopy (NIRS) is used routinely to monitor cerebral tissue oxygen saturation (SctO2) during cardiopulmonary bypass (CPB) but is rarely employed outside the operating room. Previous studies indicate that patients are at risk of postoperative cerebral oxygen desaturation after cardiac surgery.
OBJECTIVES
We aimed to assess perioperative and postoperative changes in NIRS-derived SctO2 in cardiac surgery patients.
DESIGN
Prospective observational study.
SETTING
The study was conducted in a tertiary referral university hospital in Australia from December 2017 to December 2018.
PATIENTS
We studied 34 adult patients (70.6% men) undergoing cardiac surgery requiring CPB and a reference group of 36 patients undergoing non-cardiac surgical procedures under general anaesthesia.
MAIN OUTCOME MEASURES
We measured SctO2 at baseline, during and after surgery, and then once daily until hospital discharge, for a maximum of 7 days. We used multivariate linear mixed-effects modelling to adjust for all relevant imbalances between the two groups.
RESULTS
In the cardiac surgery group, SctO2 was 63.7% [95% confidence interval (CI), 62.0 to 65.5] at baseline and 61.0% (95% CI, 59.1 to 62.9, Pā=ā0.01) on arrival in the ICU. From day 2 to day 7 after cardiac surgery, SctO2 progressively declined. At hospital discharge, SctO2 was significantly lower than baseline, at 53.5% (95% CI, 51.8 to 55.2, Pā
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Perioperative medicine Source Type: research