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The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery

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Introduction Cerebral oximetry has been widely used to measure regional oxygen saturation in brain tissue, especially during cardiac surgery. Despite its popularity, there have been inconsistent results on the use… Click to show full abstract

Introduction Cerebral oximetry has been widely used to measure regional oxygen saturation in brain tissue, especially during cardiac surgery. Despite its popularity, there have been inconsistent results on the use of cerebral oximetry during cardiac surgery, and few studies have evaluated cerebral oximetry during off pump coronary artery bypass graft surgery (OPCAB). Methods To evaluate the relationship between intraoperative cerebral oximetry and postoperative delirium in patients who underwent OPCAB, we included 1,439 patients who underwent OPCAB between October 2004 and December 2016 and among them, 815 patients with sufficient data on regional cerebral oxygen saturation (rSO2) were enrolled in this study. We retrospectively analysed perioperative variables and the reduction in rSO2 below cut-off values of 75%, 70%, 65%, 60%, 55%, 50%, 45%, 40%, and 35%. Furthermore, we evaluated the relationship between the reduction in rSO2 and postoperative delirium. Results Delirium occurred in 105 of 815 patients. In both univariable and multivariable analyses, the duration of rSO2 reduction was significantly longer in patients with delirium at cut-offs of Discussion In patients undergoing OPCAB, intraoperative rSO2 was associated with postoperative delirium. The cut-off values for intraoperative rSO2 were 50% for the total patient population and 55% for patients younger than 68 years.

Keywords: oximetry; cerebral oximetry; surgery; postoperative delirium; relationship

Journal Title: Journal of Cardiothoracic and Vascular Anesthesia
Year Published: 2020

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