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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

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Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Xi-ming Li

http://orcid.org/0000-0002-4428-9550

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

http://doi.org/10.1631/jzus.B1500030


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 People’s 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


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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.

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Abstract: 
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.

单肺通气术后认知功能障碍和脑氧饱和度关系的研究

目的:探讨单肺通气(OLV)患者术后认知功能障碍(POCD)与局部脑氧饱和度(rSO2)的关系。
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
结论:OLV患者POCD的发生与rSO2有关,rSO2监测可能是预测发生POCD的有效手段之一。

关键词:单肺通气;术后认知功能障碍;局部脑氧饱和度

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

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