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. 2015 Dec;16(12):1042-8.
doi: 10.1631/jzus.B1500030.

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Xi-ming Li  1 , Feng Li  2 , Zhong-kai Liu  1 , Ming-tao Shao  3
Affiliations

Investigation of one-lung ventilation postoperative cognitive dysfunction and regional cerebral oxygen saturation relations

Xi-ming Li et al. J Zhejiang Univ Sci B. 2015 Dec.

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 (rSO(2, min)), and the reduced maximum percentage of rSO2 (rSO(2, %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 rSO(2, %max) in the POCD group were significantly higher than those in the non-POCD group (P<0.05). When the value of rSO(2, %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.

Keywords: One-lung ventilation; Postoperative cognitive dysfunction; Regional cerebral oxygen saturation.

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Conflict of interest statement

Compliance with ethics guidelines: Xi-ming LI, Feng LI, Zhong-kai LIU, and Ming-tao SHAO declare that they have no conflict of interest.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study. Additional informed consent was obtained from all patients for whom identifying information is included in this article.

Figures

Fig. 1
Fig. 1
Receiver operating characteristic (ROC) curves of rSO2, %max AUC: area under the curve; CI: 95% confidence interval
See this image and copyright information in PMC

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