Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients a prospective observational trial 英文参考文献.docVIP

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Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients a prospective observational trial 英文参考文献.doc

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Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients a prospective observational trial 英文参考文献

Schoenetal.CriticalCare2011,15:R218 /content/15/5/R218 RESEARCH OpenAccess Preoperativeregionalcerebraloxygensaturation isapredictorofpostoperativedeliriuminon- pumpcardiacsurgerypatients:aprospective observationaltrial JulikaSchoen,JoschaMeyerrose,HaukePaarmann,MatthiasHeringlake*,MichaelHueppeandKlaus-UlrichBerger Abstract Introduction:Postoperativedeliriumisanimportantprobleminpatientsundergoingmajorsurgery.Cerebral oximetryisanon-invasivemethodtodetectimbalancesinthecerebraloxygensupply/demand-ratio.Low preoperativecerebraloxygensaturation(ScO2)levelshavebeenassociatedwithpostoperativedeliriuminnon- cardiacsurgerypatients.Thepresentprospectiveobservationalstudydeterminestherelationshipbetweenpre-and intra-operativeScO2levelsandpostoperativedeliriuminpatientsundergoingon-pumpcardiacsurgery. Methods:Afterapprovalofthelocalethicalcommitteeandwritteninformedconsent,N=231patientsscheduled forelective/urgentcardiacsurgerywereenrolled.Deliriumwasassessedbytheconfusion-assessment-methodfor theintensivecareunit(CAM-ICU)onthefirstthreedaysaftersurgery.ScO2wasobtainedonthedaybefore surgery,immediatelybeforesurgeryandthroughoutthesurgicalprocedure.Preoperativecognitivefunction, demographic,surgeryrelated,andintra-andpost-operativephysiologicaldatawereregistered. Results:Patientswithdeliriumhadlowerpre-andintra-operativeScO2readings,wereolder,hadlowermini- mental-status-examination(MMSE)scores,higheradditiveEuroScoreandlowerpreoperativehaemoglobin-levels. Thebinarylogisticregressionidentifiedolderage,lowerMMSE,neurologicalorpsychiatricdiseaseandlower preoperativeScO2asindependentpredictorsofpostoperativedelirium. Conclusions:ThepresentedstudyshowsthatalowpreoperativeScO2isassociatedwithpostoperativedelirium afteron-pumpcardiacsurgery. Introduction ofdeliriumhavebeenshowntobeassociatedwithpro- Deliriumisacommonandseriousproblemincritically longed hospital stay, increased mortality, functional illpatients[1]andoccursinupto41%[2]ofcardiacsur- decline, and long-te