老年心脏手术高血压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

拳法弓状磷一般来说减缓与神经系统出血就其。我们应用于近红外光谱线非肾结石地测定局部神经元磷一般来说。本次数据分析注意到了脑部动手拳法年长病变围拳法期脑磷一般来说减缓究竟与拳法后神经系统出血就其。

在2015年至2017年期间，我们将70岁及以上计划进行脑部手拳法的病变划定一项单中心、基础性、注意到性数据分析。拳法前一天测定所有病变脑磷一般来说基础值。在拳法中及ICU周内天气预报病变脑磷一般来说至拳法后72h。应用于ICU病变意识模糊评估单（Confusion assessment method for the ICU，CAM-ICU）评估心理疾病，应用于非校正分析和多变量Logistic回归分析评价其与心理疾病的就其性。

共有计103实有病变被划定这项基础性注意到性数据分析，移出不若有的病变后最终共有96实有病变被划定数据分析，其中29实有（30%）病变出现拳法后心理疾病。拳法弓状磷一般来说减缓与拳法后心理疾病无引人注意就其性。与无心理疾病病变来得，心理疾病病变拳法后最低脑磷一般来说高，且心理疾病病变拳法后脑磷一般来说的平方根相对下降更引人注意;忽略脑磷一般来说因素后，病变间其它差异不引人注意。高龄、中风文化史、低的EuroSCORE II平仅分、拳法前MMSE平仅分高、拳法后较引人注意的脑磷一般来说平方根减缓仅与拳法后心理疾病的发生独立就其。

接受体外循环脑部手拳法的年长病变拳法后心理疾病与脑磷一般来说减缓有关，特别是在在心理疾病发作后发挥相当引人注意。

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.