A pilot study using preoperative cerebral tissue oxygen saturation to stratify cardiovascular risk in major non-cardiac surgery
| Autor: | Alexander Z. Y. Peng, S. Cai, S. Boyle, Anders Aneman, L Pope, Matthias Jaeger, Shelly Wen, Alwin Chuan, Timothy G. Short, M. T. Tran |
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| Předmět: |
Male
medicine.medical_specialty Pilot Projects Critical Care and Intensive Care Medicine 03 medical and health sciences 0302 clinical medicine Postoperative Complications 030202 anesthesiology Risk Factors Internal medicine medicine Humans Prospective Studies Aged Aged 80 and over business.industry Brain 030208 emergency & critical care medicine Middle Aged Oxygen Anesthesiology and Pain Medicine Cardiovascular Diseases Non cardiac surgery Predictive value of tests Cardiology Female Cerebral tissue business |
| Zdroj: | Europe PubMed Central |
| Popis: | This prospective pilot study evaluated whether low preoperative cerebral tissue oxygen saturation is associated with unfavourable outcomes after major elective non-cardiac surgery. Eighty-one patients over 60 years of age, American Society of Anesthesiologists physical status 3 or 4, were recruited. Resting cerebral tissue oxygen saturation was recorded on room air, and after oxygen supplementation, using cerebral oximetry. The primary outcome was 30-day major adverse event of combined mortality or severe morbidity, and the secondary outcome was 30-day new disability. Eleven patients (13.6%) suffered a major adverse event, and 28 patients (34.6%) experienced new disability. Room air cerebral tissue oxygen saturation was significantly different between patients who had a major adverse event, 67% (95% confidence interval [CI] 65–70) versus unaffected, 71% (95% CI 70–72; P=0.04). No statistical difference was found between patients for new disability (range 70%– 74%; P=0.73). Room air cerebral tissue oxygen saturation was significantly associated with major adverse events (odds ratio 1.36 (95% CI 1.03–1.79), P=0.03). Saturation levels ≤68% carried a positive likelihood ratio of 2.2 for death or severe morbidity, P=0.04. A definitive trial is required to confirm if cerebral oximetry can be used to stratify the cardiovascular risk of patients presenting for non-cardiac surgery. |
| Databáze: | OpenAIRE |
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