PMID- 18272385
OWN - NLM
STAT- MEDLINE
DCOM- 20080812
LR  - 20191210
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 33
IP  - 4
DP  - 2008 Apr
TI  - Prediction of cognitive dysfunction and patients' outcome following valvular 
      heart surgery and the role of cerebral oximetry.
PG  - 560-5
LID - 10.1016/j.ejcts.2008.01.012 [doi]
AB  - OBJECTIVE: Postoperative cognitive dysfunction (POCD) commonly develops after 
      cardiac surgery affecting patients' outcome. Cerebral oximetry noninvasively 
      measures regional cerebral oxygen saturation (rSO(2)) and significant correlation 
      has been reported between intraoperative cerebral desaturation and POCD, as well 
      as patients' outcome following coronary artery bypass grafting. However, evidence 
      is limited in valvular heart surgery (VHS). We investigated the relationship of 
      intraoperative rSO(2) values with POCD and length of postoperative 
      hospitalization in patients undergoing VHS. METHODS: One hundred patients 
      undergoing elective VHS were enrolled. Neurocognitive evaluation was performed 
      with Mini-Mental State Examination, Trail-Making Test (Part A), and Grooved 
      Pegboard Test at 1 day before and 7th day after surgery. During surgery, rSO(2) 
      was continuously monitored and the incidence and duration of decrease in rSO(2) 
      values for five consecutive minutes were recorded as follows; (1) decrease in 
      absolute rSO(2) values to less than 50%, (2) 40%, and (3) a 20% decrease compared 
      to baseline value. RESULTS: Twenty-three patients (23%) demonstrated POCD. We 
      could not observe any significant differences in either the incidence or duration 
      of decrease in rSO(2) values between patients with and without POCD. Low 
      education level and higher baseline temperature had significant correlation with 
      POCD. Patients with cerebral desaturation required significantly longer 
      postoperative hospitalization. CONCLUSION: In patients undergoing VHS, POCD could 
      not be predicted with cerebral oximetry. However, patients with intraoperative 
      cerebral desaturation required significantly longer postoperative hospitalization 
      and cerebral oximetry appears to be promising in terms of monitoring the brain as 
      the index organ for systemic perfusion and improving patients' outcome.
FAU - Hong, Seong Wook
AU  - Hong SW
AD  - Department of Anesthesiology and Pain Medicine, Yonsei University College of 
      Medicine, 134 Shinchon-Dong, Seadaemun-Ku, Seoul 120-752, South Korea.
FAU - Shim, Jae Kwang
AU  - Shim JK
FAU - Choi, Yong Seon
AU  - Choi YS
FAU - Kim, Dae Hee
AU  - Kim DH
FAU - Chang, Byung Chul
AU  - Chang BC
FAU - Kwak, Young Lan
AU  - Kwak YL
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20080212
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Body Temperature/physiology
MH  - Brain/*metabolism
MH  - Cerebrovascular Circulation/*physiology
MH  - Cognition Disorders/*diagnosis/etiology/psychology
MH  - Coronary Artery Bypass/methods/rehabilitation
MH  - Educational Status
MH  - Female
MH  - Heart Valve Diseases/*surgery
MH  - Heart Valves/physiopathology/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/methods
MH  - Neuropsychological Tests/standards
MH  - Oximetry/*methods
MH  - Oxygen/*metabolism
MH  - Postoperative Care/methods
MH  - Predictive Value of Tests
MH  - Spectroscopy, Near-Infrared/methods
MH  - Treatment Outcome
EDAT- 2008/02/15 09:00
MHDA- 2008/08/13 09:00
CRDT- 2008/02/15 09:00
PHST- 2007/10/16 00:00 [received]
PHST- 2007/12/29 00:00 [revised]
PHST- 2008/01/08 00:00 [accepted]
PHST- 2008/02/15 09:00 [pubmed]
PHST- 2008/08/13 09:00 [medline]
PHST- 2008/02/15 09:00 [entrez]
AID - S1010-7940(08)00042-0 [pii]
AID - 10.1016/j.ejcts.2008.01.012 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2008 Apr;33(4):560-5. doi: 10.1016/j.ejcts.2008.01.012. 
      Epub 2008 Feb 12.