Full Text:   <2384>

Summary:  <1669>

CLC number: R74; R61

On-line Access: 2015-12-04

Received: 2015-01-29

Revision Accepted: 2015-07-06

Crosschecked: 2015-11-30

Cited: 2

Clicked: 3936

Citations:  Bibtex RefMan EndNote GB/T7714


Xi-ming Li


-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2015 Vol.16 No.12 P.1042-1048


Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Author(s):  Xi-ming Li, Feng Li, Zhong-kai Liu, Ming-tao Shao

Affiliation(s):  Department of Anesthesiology, Linyi City Peoples Hospital, Linyi 276000, China; more

Corresponding email(s):   13515397176@163.com, bcxqywb@163.com

Key Words:  One-lung ventilation, Postoperative cognitive dysfunction, Regional cerebral oxygen saturation

Share this article to: More <<< Previous Article|

Xi-ming Li, Feng Li, Zhong-kai Liu, Ming-tao Shao. Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations[J]. Journal of Zhejiang University Science B, 2015, 16(12): 1042-1048.

@article{title="Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations",
author="Xi-ming Li, Feng Li, Zhong-kai Liu, Ming-tao Shao",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations
%A Xi-ming Li
%A Feng Li
%A Zhong-kai Liu
%A Ming-tao Shao
%J Journal of Zhejiang University SCIENCE B
%V 16
%N 12
%P 1042-1048
%@ 1673-1581
%D 2015
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1500030

T1 - Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations
A1 - Xi-ming Li
A1 - Feng Li
A1 - Zhong-kai Liu
A1 - Ming-tao Shao
J0 - Journal of Zhejiang University Science B
VL - 16
IS - 12
SP - 1042
EP - 1048
%@ 1673-1581
Y1 - 2015
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1500030

Objective: To explore the relationship of postoperative cognitive dysfunction (POCD) in one-lung ventilation (OLV) patients and regional cerebral oxygen saturation (rSO2). Methods: Twenty-nine male and twenty-one female cases of OLV received thoracic surgery, with American Standards Association (ASA) physical status being at Grades I–III. Neuropsychological tests were performed on the day before operation and 7 d after operation, and there was an intraoperative continuous monitoring of rSO2. The values of rSO2 before anesthesia induction (t1), at the beginning of OLV (t2), and at the time of OLV 30 min (t3), OLV 60 min (t4), the end of OLV (t5), and the end of surgery (t6) were recorded. The intraoperative average of rSO2, the intraoperative minimum value of rSO2 (rSO2, min), and the reduced maximum percentage of rSO2 (rSO2, %max) when compared with the baseline value were calculated. The volume of blood loss, urine output, and the amount of fluid infusion was recorded. Results: A total of 14 patients (28%) in the 50 cases suffered from POCD. The values of mini-mental state examination (MMSE), the digit span and the digit symbol on the 7th day after the operation for POCD in OLV patients were found to be significantly lower than those before the operation (P<0.05). The values of MMSE and vocabulary fluency scores were significantly lower than those in the non-POCD group (P<0.05). The values of rSO2 in the POCD group of OLV patients at t2 and t3 and the values of rSO2 in the non-POCD group at t2 were found to be significantly higher than those at t1 (P<0.05). The values of rSO2, %max in the POCD group were significantly higher than those in the non-POCD group (P<0.05). When the value of rSO2, %max is more than 10.1%, it may act as an early warning index for cognitive function changes. Conclusions: POCD after OLV may be associated with a decline in rSO2.


创新点:POCD的发生与患者年龄及术中rSOv较基础值下降的最大百分数(rSO2, %max)密切相关,术中rSO2, %max>10.1%时,提示可能发生POCD。术中rSO2监测可作为POCD的预测手段。
方法:择期行OLV开胸手术患者50例(美国标准协会(ASA)分级I~III),于术前1天和术后7天分别进行神经心理测验。术中利用近红外光谱技术(NIRS)连续监测rSO2,并计算麻醉诱导前(t1)、单肺通气开始(t2)、单肺通气30 min(t3)、单肺通气60 min(t4)、单肺通气结束(t5)和手术结束(t6)时刻的平均脑氧饱和度、rSO2最小值(rSO2 min)和rSO2, %max


Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


[1]Abildstrom, H., Rasmussen, L.S., Rentowl, P., et al., 2000. Cognitive dysfunction l–2 years after noncardiac surgery in the elderly. Acta Anaesthesiol., Scand., 44(10):1246-1251.

[2]Blas, M., Sulek, C., Martin, T., et al., 1999. Use of near-infrared spectroscopy to monitor cerebral oxygen at ion during coronary artery bypass surgery in a patient with bilateral internal carotid artery occlusion. Cardiothorac. Vasc. Anesth., 13(6):732-735.

[3]Canet, J., Raeder, J., Rasmussen, L.S., et al., 2003. Cognitive dysfunction after minor surgery in the elderly. J. Acta Anaesthesiol. Scand., 47(10):1204-1210.

[4]Casati, A., Fanelli, G., Pietropaoli, P., et al., 2005. Continuous monitoring of cerebral oxygen saturation in elderly patients undergoing major abdominal surgery minimizes brain exposure to potential hypoxia. Anesth. Analg., 101:740-747.

[5]Farag, E., Chelune, G.J., Schubert, A., et al., 2006. Is depth of anesthesia as assessed by bispectral index, related to post-operative cognitive dysfunction and recovery? Anesth. Analg., 103(3):633-640.

[6]Folstein, M.F., Folstein, S.E., McHugh, P.R., 1975. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res., 12(3):189-198.

[7]Funder, K.S., Steinmetz, J., Rasmussen, L.S., 2010. Methodological issues of postoperative cognitive dysfunction research. Semin Cardiothorac. Vasc. Anesth., 14(2):119-122.

[8]Grilli, M., Goffi, F., Memo, M., et al., 1996. Interleukin-1β and glutamate activate the NF-κB/Rel binding site from the regulatory region of the amyloid precursor protein gene in primary neuronal cultures. J. Biol. Chem., 271(25):15002-15007.

[9]Hong, S.W., Shim, J.K., Choi, Y.S., et al., 2008. Prediction of cognitive dysfunction and patients’ outcome following valvular heart surgery and the role of cerebral oximetry. Eur. J. Cardiothorac. Surg., 33(4):560-565.

[10]Johnson, T., Monk, T., Rasmussen, L.S., et al., 2002. Postoperative cognitive dysfunction in middle-aged patients. Anesthesiology, 96(6):1351-1357.

[11]Karzai, W., Schwarzkopf, K., 2009. Hypoxemia during one-lung ventilation: prediction, prevention and treatment. Anesthesiology, 110(6):1402-1411.

[12]Kienlen-Campard, P., Tasiaux, B., Octave, J.N., 2000. The processing and biological function of the human amyloid precursor protein (APP): lessons from different cellular models. Exp. Gerontol., 35(6-7):843-850.

[13]Li, X.M., Shao, M.T., Wang, J.J., et al., 2014. Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein. J. Zhejiang Univ.-Sci. B (Biomed. & Biotechnol.), 15(10):870-878.

[14]Lin, R., Zhang, F.J., Xue, Q.S., et al., 2013. Accuracy of regional cerebral oxygen saturation in predicting postoperative cognitive dysfunction after total hip arthroplasty. J. Arthroplasty, 28(3):494-497.

[15]Moller, J.T., Cluitmans, P., Rasmussen, L.S., et al., 1998. Long-term postoperative cognitive dysfunction in the elderly: ISPOCD1 study. Lancet, 351(9106):857-861.

[16]Monk, T.G., Weldon, B.C., Garvan, C.W., et al., 2008. Predictors of cognitive dysfunction after majornoncardiac surgery. Anesthesiology, 108(1):18-30.

[17]Murkin, J.M., Adams, S.J., Novick, R.J., et al., 2007. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth. Analg., 104(1):51-58.

[18]Olsen, K.S., Svendsen, L.B., Larsen, F.S., 1996. Validation of transcranial near-infrared spectroscopy for evaluation ofcerebral blood flow autoregulation. J. Neurosurg. Anesthesiol., 8(4):280-285.

[19]Rasmussen, L.S., 2006. Postoperative cognitive dysfunction: incidence and prevention. Best Pract. Res. Clin. Anesth., 20(2):315-330.

[20]Silverstein, J.H., Jefrey, H., 2007. Central nervous system dyrsfunction after noncardiac surgery and anesthesia in the elderly. Anesthesiology, 106(3):622-628.

[21]Singh-Manoux, A., Kivimaki, M., Glymour, M.M., et al., 2012. Timing of onset of cognitive decline: results from Whitehall II prospective cohort study. BMJ, 344:d7622.

[22]Slater, J.P., Guarino, T., Stack, J., et al., 2009. Cerebraloxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann. Thorac. Surg., 87(1):36-44.

[23]Stephan, A., Laroche, S., Davis, S., 2003. Learning deficits and dysfunctional synaptic plasticity induced by aggregated amyloid deposits in the dentate gyrus are rescued by chronic treatment with indomethacin. Eur. J. Neurosci., 17(9):1921-1927.

[24]Townsend, K.P., Obregon, D., Quadros, A., et al., 2002. Proinflammatory and vasoactive effects of Aβ in the cerebrovasculature. Ann. NY. Acad. Sci., 977(1):65-76.

[25]Yao, F.S.F., Tseng, C.C., Ho, C.Y.A., et al., 2004. Cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery. J. Cardiothorac. Vasc. Anesth., 18(5):552-558.

Open peer comments: Debate/Discuss/Question/Opinion


Please provide your name, email address and a comment

Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2024 Journal of Zhejiang University-SCIENCE