scholarly journals Effects of electroencephalography and regional cerebral oxygen saturation monitoring on perioperative neurocognitive disorders: a systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lin Ding ◽  
Dong Xu Chen ◽  
Qian Li
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Neurocognitive Disorders ◽  
Cerebral Oxygen Saturation ◽  
Cochrane Library ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation ◽  
Cerebral Function ◽  
Postoperative Cognitive Decline ◽  
Significant Difference

Abstract Background Perioperative neurocognitive disorders (PND) is a common postoperative complication including postoperative delirium (POD), postoperative cognitive decline (POCD) or delayed neurocognitive recovery. It is still controversial whether the use of intraoperative cerebral function monitoring can decrease the incidence of PND. The purpose of this study was to evaluate the effects of different cerebral function monitoring (electroencephalography (EEG) and regional cerebral oxygen saturation (rSO2) monitoring) on PND based on the data from randomized controlled trials (RCTs). Methods The electronic databases of Ovid MEDLINE, PubMed, EMBASE, Cochrane Library database were systematically searched using the indicated keywords from their inception to April 2020. The odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were employed to analyze the data. Heterogeneity across analyzed studies was assessed with chi-square test and I2 test. Results Twenty two RCTs with 6356 patients were included in the final analysis. Data from 12 studies including 4976 patients were analyzed to assess the association between the EEG-guided anesthesia and PND. The results showed that EEG-guided anesthesia could reduce the incidence of POD in patients undergoing non-cardiac surgery (OR: 0.73; 95% CI: 0.57–0.95; P = 0.02), but had no effect on patients undergoing cardiac surgery (OR: 0.44; 95% CI: 0.05–3.54; P = 0.44). The use of intraoperative EEG monitoring reduced the incidence of POCD up to 3 months after the surgery (OR: 0.69; 95% CI: 0.49–0.96; P = 0.03), but the incidence of early POCD remained unaffected (OR: 0.61; 95% CI: 0.35–1.07; P = 0.09). The remaining 10 studies compared the effect of rSO2 monitoring to routine care in a total of 1380 participants on the incidence of PND. The results indicated that intraoperative monitoring of rSO2 could reduce the incidence of POCD (OR 0.53, 95% CI 0.39–0.73; P < 0.0001), whereas no significant difference was found regarding the incidence of POD (OR: 0.74; 95% CI: 0.48–1.14; P = 0.17). Conclusions The findings in the present study indicated that intraoperative use of EEG or/and rSO2 monitor could decrease the risk of PND. Trial registration PROSPREO registration number: CRD42019130512.

scholarly journals Comparison of basic regional cerebral oxygen saturation values in patients of different ages: a pilot study

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093686
Author(s):  
Chaohui Lian ◽  
Peng Li ◽  
Ning Wang ◽  
Yi Lu ◽  
Wangning Shangguan
Keyword(s):  
Oxygen Saturation ◽  
Elective Surgery ◽  
Age Groups ◽  
The Elderly ◽  
Preschool Age ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
School Age ◽  
Regional Cerebral Oxygen Saturation ◽  
Significant Difference

Objective To explore the basic values of regional cerebral oxygen saturation (rSO2) among different age groups. Methods One hundred twenty patients who were scheduled for elective surgery aged 0 to 80 years (American Society of Anesthesiologists [ASA] physical status I or II) or neonates just after birth via cesarean section were enrolled and divided into the following six groups: infant (0 month and ≤12 months), toddler (>1 and ≤3 years old), preschool (>3 and ≤6 years old), school age (>6 and ≤18 years old), adult (>18 and ≤65 years old), and elderly (>65 and ≤80 years old) groups. There were 20 patients in each group. Results The basic values of rSO2 in infant, toddler, preschool, school age, adults, and elderly groups were 70.41% ± 4.66%, 72.43% ± 3.81%, 70.77% ± 3.27%, 70.62% ± 2.20%, 69.76% ± 6.02%, and 62.69% ± 3.14%, respectively. The basic value in the elderly group was lower compared with other five groups. There was no significant difference among infant, toddler, preschool age, school age, and adult groups. Conclusions The basic value of rSO2 in elderly patients is lower. Age is an important factor that affects the underlying value of rSO2.

Near-infrared spectroscopy as a possible device for continuous monitoring of arterial carbon dioxide tension during cardiac surgery

Perfusion ◽  
2011 ◽  
Vol 26 (6) ◽  
pp. 524-528 ◽  
Author(s):  
CS Park ◽  
JG Kwak ◽  
C Lee ◽  
C-H Lee ◽  
SK Lee ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Continuous Monitoring ◽  
Near Infrared ◽  
Right Hemisphere ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation

Background: Insufflation of carbon dioxide (CO2) to the operative field has been used to prevent major organ injury attributed to air embolisms in cardiac surgery. However, it may be preferable to avoid hypercapnia induced by CO2 insufflation, owing to its potentially harmful effect. To investigate the effectiveness of near-infrared spectroscopy (NIRS) as a possible method for continuous monitoring of arterial CO2 tension during cardiac surgery, we evaluated the correlation between the change in arterial CO2 tension and the change in regional cerebral oxygen saturation (rScO2) obtained from NIRS in as controlled a condition as possible. Methods: Thirty patients who underwent surgical correction for atrial or ventricular septal defects were enrolled in this study. Patients who had pulmonary hypertension or other intracardiac anomalies were excluded. Anesthetic and cardiopulmonary bypass (CPB) management were conducted according to our standard institutional practice. Data obtained from arterial blood gas analyses and corresponding regional cerebral oxygen saturation (rScO2) recorded from NIRS before and after the insufflations of CO2 during CPB were used for analysis. Results: The change in arterial CO2 tension correlated with the change in rScO2 in the left hemisphere (r = 0.681, p <0.001, y = −1.393 + 0.547x) and right hemisphere (r = 0.690, p <0.001, y = −1.999 + 0.486x). To control the effects of other variables, including hematocrit and temperature, these relationship were not reduced (left hemisphere: r=0.678, p<0.001; right hemisphere: r=0.634, p<0.001). Conclusions: Since the change in regional cerebral oxygen saturation was correlated with the change in arterial CO2 tension during mild hypothermic CPB, NIRS might be a possible non-invasive method for monitoring of arterial CO2 tension without incurring additional cost in this setting.

scholarly journals Correlation among decreased regional cerebral oxygen saturation, blood levels of brain injury biomarkers, and cognitive disorder

2018 ◽  
Vol 46 (9) ◽  
pp. 3621-3629 ◽  
Author(s):  
Birute Kumpaitiene ◽  
Milda Svagzdiene ◽  
Ingrida Drigotiene ◽  
Edmundas Sirvinskas ◽  
Ramune Sepetiene ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Brain Injury ◽  
Oxygen Saturation ◽  
Blood Level ◽  
Cognitive Disorder ◽  
Cerebral Oxygen Saturation ◽  
Blood Levels ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation ◽  
Test Digit

Objective This study was performed to investigate the correlation among decreased regional cerebral oxygen saturation (rSO2), blood levels of brain injury biomarkers, and postoperative cognitive disorder (POCD) after cardiac surgery with cardiopulmonary bypass (CPB). Methods This prospective observational study included 59 patients undergoing coronary artery bypass graft surgery with CPB. All patients underwent neuropsychological tests (Mini Mental State Evaluation, Rey Auditory Verbal Learning Test, digit span test, digit symbol substitution test, and Schulte table) the day before and 10 days after the surgery. The blood levels of two brain injury biomarkers, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), were measured before and 1 day after the surgery. Results The rSO2 decreased during surgery in 21 (35%) patients. POCD was detected in 22 (37%) patients. After the surgery, no significant changes in the GFAP blood level occurred in any patients. No significant correlations were found among the decreased rSO2, increased NSE blood level, and rate of POCD. Conclusion These results suggest that a decrease in rSO2 during cardiac surgery is not necessarily related to the development of POCD or an increased blood level of the brain injury biomarker NSE.

Effects of Dexmedetomidine on cerebral oxygen saturation in patients undergoing laparoscopic hysterectomy: a randomised ,parallel-group study

2019 ◽  
Author(s):  
Qianqian Yang ◽  
Haitao Qian ◽  
Bing Wang ◽  
Fenyu Duan ◽  
Mengxun Zhu ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Laparoscopic Hysterectomy ◽  
Cerebral Oxygen Saturation ◽  
Control Group ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation ◽  
Clinical Trial Registry ◽  
Trendelenburg Position ◽  
Significant Difference ◽  
The Relationship

Abstract Abstract Background:This study is to investigate the relationship between the Trendelenburg position and regional cerebral oxygen saturation (rSO2) during laparoscopic hysterectomy and possible effects of Dexmedetomidine on cerebral hypoxia of patients undergoing this surgery. Methods: Randomized, prospective and single-blinded study. Patients aged 20 to 65 years are enrolled in this trial,25 in each group. Saline and Dexmedetomidine were infused into petients of Control group and Dexmedetomidine group respectively. Regional cerebral oxygen saturation (rSO2) and hemodynamic parameters were recorded before and after induction of anesthesia and once every 20 min in the Trendelenburg position and 10 min after supine position. We determined prospectively the association of the development of cerebral desaturation and the patient’s position with clinical outcomes of the entire surgery. Results: There was no significant difference between these groups according to demographic characteristics. Right and left rSO2 values of patients in control group decreased at 20 min,40 min and 60 min in the Trendelenburg position, but they increased 10 min after changed to supine position.For Dexmedetomidine group,rSO2 were improved during the Trendelenburg position constantly. The relationship between rSO2 values and cognitive dysfunction was not significant. Conclusion:Dexmedetomidine provides higher rcSO2 values during the Trendelenburg position for laparoscopic hysterectomy. Trial registration: Chinese Clinical Trial Registry. No: ChiCTR1800019174. Prospective registration. Key words: NIRS,rSO2,Trendelenburg position, Dexmedetomidine

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