preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on-pump cardiac surgery patients a prospective observational trial术前区域脑氧饱和度是体外循环心脏手术患者术后谵妄的预测未来的观测试验.pdfVIP

Schoen et al. Critical Care 2011, 15:R218 /content/15/5/R218 RESEARCH Open Access Preoperative regional cerebral oxygen saturation is a predictor of postoperative delirium in on- pump cardiac surgery patients: a prospective observational trial * Julika Schoen, Joscha Meyerrose, Hauke Paarmann, Matthias Heringlake , Michael Hueppe and Klaus-Ulrich Berger Abstract Introduction: Postoperative delirium is an important problem in patients undergoing major surgery. Cerebral oximetry is a non-invasive method to detect imbalances in the cerebral oxygen supply/demand-ratio. Low preoperative cerebral oxygen saturation (ScO2) levels have been associated with postoperative delirium in non- cardiac surgery patients. The present prospective observational study determines the relationship between pre- and intra-operative ScO2 levels and postoperative delirium in patients undergoing on-pump cardiac surgery. Methods: After approval of the local ethical committee and written informed consent, N = 231 patients scheduled for elective/urgent cardiac surgery were enrolled. Delirium was assessed by the confusion-assessment-method for the intensive care unit (CAM-ICU) on the first three days after surgery. ScO2 was obtained on the day before surgery, immediately before surgery and throughout the surgical procedure. Preoperative cognitive function, demographic, surgery related, and intra- and post-operative physiological data were registered. Results: Patients with delirium had lower pre- and intra-operative ScO2 readings, were older, had lower mini- mental-status-examination(MMSE) scores, higher additive EuroScore and lower preoperative haemoglobin-levels. The binary logistic regression identified older age, lower MMSE, neurologica