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[The correlation between tissue oxygen saturation and postoperative cognitive dysfunction in elderly patients with
1Department of Anesthesiology and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China.
Zhonghua Yi Xue Za Zhi
|November 9, 2020
Summary
Cerebral desaturation during one lung ventilation is a key risk factor for postoperative neurocognitive dysfunction (PND) in elderly thoracic surgery patients. Muscle oxygen saturation showed no correlation with PND, highlighting the importance of monitoring brain oxygen levels.
Area of Science:
- Anesthesiology and Perioperative Medicine
- Neuroscience and Neurology
- Thoracic Surgery
Background:
- Postoperative neurocognitive dysfunction (PND) is a significant concern in elderly patients undergoing thoracic surgery.
- One lung ventilation (OLV) is a critical component of thoracic surgery that can impact systemic oxygenation.
- The relationship between intraoperative tissue oxygen saturation and PND remains incompletely understood.
Purpose of the Study:
- To investigate the correlation between tissue oxygen saturation during OLV and the incidence of PND in elderly patients.
- To identify independent risk factors for PND in this patient population.
Main Methods:
- A cohort of 128 elderly patients undergoing selective lobectomy were monitored for tissue oxygen saturation (SmtO2) in the forebrain, brachioradialis muscle, and quadriceps.
- Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) preoperatively and on postoperative day 3.
- PND was defined as a decrease of at least 2 MoCA scores postoperatively. Logistic regression was employed to identify risk factors.
Main Results:
- The incidence of PND was 26.6%.
- The length of postoperative hospital stay was significantly longer in the PND group compared to the non-PND group.
- Multivariate analysis identified high American Society of Anesthesiologists (ASA) grade and minimum cerebral oxygen saturation during OLV as independent risk factors for PND. Muscle oxygen saturation showed no correlation with PND.
Conclusions:
- Cerebral desaturation during one lung ventilation is a significant independent risk factor for developing postoperative neurocognitive dysfunction in elderly patients undergoing thoracic surgery.
- Monitoring cerebral oxygen saturation during OLV is crucial for mitigating the risk of PND.
- Muscle oxygen saturation does not appear to be statistically correlated with PND in this cohort.
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