The influence of oxygen delivery during cardiopulmonary bypass on the incidence of delirium in CABG patients; a retrospective study

Autor: Hanna D. Golab, Ed Overdevest, Jori Leenders, Bart van Straten
Přispěvatelé: Cardiothoracic Surgery
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Neurological complication
030204 cardiovascular system & hematology
behavioral disciplines and activities
law.invention
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
law
mental disorders
oxygen delivery
Cardiopulmonary bypass
medicine
Humans
Radiology
Nuclear Medicine and imaging
Postoperative delirium
Coronary Artery Bypass
CABG
Aged
Retrospective Studies
Advanced and Specialized Nursing
Cardiopulmonary Bypass
business.industry
Incidence
Delirium
030208 emergency & critical care medicine
Retrospective cohort study
General Medicine
Hypoxia (medical)
Middle Aged
Original Papers
Cardiac surgery
nervous system diseases
Oxygen
Anesthesia
Oxygen delivery
Haloperidol
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Safety Research
Zdroj: Perfusion
Perfusion-Uk, 33(8), 656-662. SAGE Publications Ltd
ISSN: 1477-111X
0267-6591
Popis: Introduction: Postoperative delirium is the most common neurological complication of cardiac surgery. Hypoxia has been shown to increase the risk of postoperative delirium. The possibility to continuously monitor oxygen delivery (DO2) during cardiopulmonary bypass (CPB) offers an adequate approximation of the oxygen status in a patient. This study investigates the role of oxygen delivery during cardiopulmonary bypass in the incidence of postoperative delirium. Methods: Three hundred and fifty-seven adult patients who underwent normothermic coronary artery bypass grafting (CABG) surgery were included in this retrospective study. The nadir indexed DO2 (DO2i) value on bypass, the total time under the critical DO2i level and the area under the curve (AUC) for critical DO2i were determined. Delirium was identified by the postoperative administration of haloperidol. Results: The mean nadir DO2i significantly differed, comparing the group of patients with postoperative delirium to the group without. Multivariate analysis only identified age, pre-existing cognitive impairment, preoperative kidney dysfunction and cross-clamp time as independent risk factors for delirium. The results also indicated that patients of older age were more sensitive to a declined DO2i. Conclusion: A low DO2i during cardiopulmonary bypass is significantly associated with the incidence of postoperative delirium in CABG patients. However, the role of DO2 as an independent predictor of delirium could not be proven.
Databáze: OpenAIRE
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