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学科主题: 临床医学
题名:
Cerebral oxygen saturation after multiple perioperative influential factors predicts the occurrence of postoperative cognitive dysfunction
作者: Ni, Cheng1; Xu, Ting1; Li, Nan2; Tian, Yang1; Han, Yongzheng1; Xue, Qingsheng3; Li, Min1; Guo, Xiangyang1
关键词: Cerebral oxygen saturation ; Postoperative cognitive dysfunction ; Elderly patient ; Total knee arthroplasty ; Perioperative influential factors
刊名: BMC ANESTHESIOLOGY
发表日期: 2015-10-26
DOI: 10.1186/s12871-015-0117-6
卷: 15
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Anesthesiology
研究领域[WOS]: Anesthesiology
关键词[WOS]: TOTAL KNEE REPLACEMENT ; NEAR-INFRARED SPECTROSCOPY ; HOSPITAL CARDIAC-ARREST ; CARDIOPULMONARY BYPASS ; CAROTID-ENDARTERECTOMY ; TOTAL HIP ; SURGERY ; BRAIN ; ARTHROPLASTY ; OXIMETRY
英文摘要:

Background: Postoperative cognitive dysfunction (POCD) is a frequent complication in elderly patients undergoing major non-cardiac surgery, but its etiology is still unclear. Cerebral oxygen saturation (ScO2) represents the balance of cerebral oxygen supply and demand. The aim of present study was to evaluate the relationship between perioperative ScO2 and POCD, and to verify the hypothesis that the value of ScO2 after multiple perioperative influential factors could predict POCD in elderly patients undergoing total knee arthroplasty (TKA).

Methods: Seventy eight Patients aged more than 65 years undergoing elective TKA with intrathecal anesthesia were enrolled. Cognitive functions were assessed one day before and 6 days after surgery, and POCD were defined according to ISPOCD. Demographics were recorded. Perioperative ScO2, blood pressure (BP), blood gas analysis and other clinical data were monitored and recorded, then the decrease of ScO2, BP and PaO2 after influential factors were calculated.

Results: POCD occurred in 15 patients (19.2 %). BP decreased after anesthesia induction and tourniquet deflation, and PaO2 decreased after cement implantation was higher in POCD group. ScO2 of POCD group is significantly lower than non-POCD group (P < 0.05), and the absolute value and percentage decrease of ScO2 became significant between two groups after multiple influential factors. ScO2 after all influential factors (anesthesia induction, cement implantation and tourniquet deflation) had the best predictive performance for POCD (AUC = 0.742), and the optimal threshold was 66.5 %.

Conclusions: Perioperative ScO2 of patients with POCD is lower than patients without POCD. ScO2 after multiple perioperative influential factors could be an effective predictor for POCD, which reveal an important role of ScO2 decrease in the development of POCD and provide possible treatment target.

语种: 英语
所属项目编号: 2011-4023-04 ; 81400869
项目资助者: Capital Foundation for Medical Research and Development ; National Natural Science Foundation Of China
WOS记录号: WOS:000363444500002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/52715
Appears in Collections:北京大学第三临床医学院_麻醉科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Dept Anesthesiol, Beijing 100191, Peoples R China
2.Peking Univ, Hosp 3, Res Ctr Clin Epidemiol, Beijing 100191, Peoples R China
3.Shanghai Jiao Tong Univ, Sch Med, Ruijin Hosp, Dept Anesthesiol, Shanghai 200025, Peoples R China

Recommended Citation:
Ni, Cheng,Xu, Ting,Li, Nan,et al. Cerebral oxygen saturation after multiple perioperative influential factors predicts the occurrence of postoperative cognitive dysfunction[J]. BMC ANESTHESIOLOGY,2015,15.
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