老年心脏疗程患者术后谵妄与脑氧饱和度降低的关系

Association Between Postoperative Delirium and Postoperative Cerebral Oxygen Desaturation in Older Patients After Cardiac Surgery

绝技小脑碳一般而言增加与神经系统癌症就其。我们应用于近红外星体非侵入连续性地计算暂时性大脑碳一般而言。本次学绝技研究推论了脊柱疗程后年长高血压围绝技期脑碳一般而言增加是不是与绝技后神经系统癌症就其。

在2015年至2017年此后，我们将70岁及以上计划透过脊柱疗程的高血压归入一项单中心、前瞻连续性、推论连续性学绝技研究。绝技前一天计算所有高血压脑碳一般而言基础值。在绝技中及ICU连续监控高血压脑碳一般而言至绝技后72h。应用于ICU高血压意识模糊风险评估单（Confusion assessment method for the ICU，CAM-ICU）风险评估中毒者，引入非校正研究和多参数Logistic回归研究评价其与中毒者的关联连续性。

共计103事例高血压被归入这项前瞻连续性推论连续性学绝技研究，去除不满足条件的高血压后最终共96事例高血压被归入建模，其中29事例（30%）高血压出现绝技后中毒者。绝技小脑碳一般而言增加与绝技后中毒者无值得注意关联连续性。与无中毒者高血压相比，中毒者高血压绝技后下限脑碳一般而言更高，且中毒者高血压绝技后脑碳一般而言的个数相对下降更值得注意;排除脑碳一般而言因素后，高血压间其它差异不值得注意。据闻、心肌梗塞两书、较高的EuroSCORE II打分、绝技前MMSE打分更高、绝技后较值得注意的脑碳一般而言个数增加均与绝技后中毒者的发生独立就其。

接受体外循环脊柱疗程的年长高血压绝技后中毒者与脑碳一般而言增加有关，更是在中毒者头痛后表现更为值得注意。

Eertmans W,De Deyne C,Genbrugge C,et al.Association Between Postoperative Delirium and Postoperative Cerebral Oxygen Desaturation in Older Patients After Cardiac Surgery. Br J Anaesth 2020; 124 (2): 146-153.

Background: Near-infrared spectroscopy non-invasively measures regional cerebral oxygen saturation. Intraoperative cerebral desaturations he been associated with worse neurological outcomes. We investigated whether perioperative cerebral desaturations are associated with postoperative delirium in older patients after cardiac surgery.Methods: Patients aged 70 yr and older scheduled for on-pump cardiac surgery were included between 2015 and 2017 in a single-centre, prospective, observational study. Baseline cerebral oxygen saturation was measured 1 day before surgery.Throughout surgery and after ICU admission, cerebral oxygen saturation was monitored continuously up to 72 h after operation. The presence of delirium was assessed using the confusion assessment method for the ICU. Association with delirium was evaluated with unadjusted yses and multivariable logistic regression.Results: Ninety-six of 103 patients were included, and 29 (30%) became delirious. Intraoperative cerebral oxygen saturation was not significantly associated with postoperative delirium. The lowest postoperative cerebral oxygen saturation was lower in patients who became delirious (P¼0.001). The absolute and relative postoperative cerebral oxygen saturation decreases were more marked in patients with delirium (13 [6]% and 19 [9]%, respectively) compared with patients without delirium (9 [4]% and 14 [5]%; P¼0.002 and P¼0.001, respectively). These differences in cerebral oxygen saturation were no longer present after excluding cerebral oxygen saturation values after patients became delirious. Older age,previous stroke, higher EuroSCORE II, lower preoperative Mini-Mental Status Examination, and more substantial absolute postoperative cerebral oxygen saturation decreases were independently associated with postoperative delirium incidence.Conclusions: Postoperative delirium in older patients undergoing cardiac surgery is associated with absolute decreases in postoperative cerebral oxygen saturation. These differences appear most detectable after the onset of delirium.