Impact of controlled hypotension by cerebral oxygen saturation monitoring on brain protection and cognitive function in anesthesia patients
- VernacularTitle:脑氧饱和度监测控制性降压对麻醉患者脑保护及认知的影响
- Author:
Manman HE
1
;
Ping HE
;
Jiong SHI
;
Yang GAO
Author Information
- Keywords: cerebral oxygen saturation monitoring; controlled hypotension; brain protection; postoperative neurocognitive disorder; vascular surgery
- From: Journal of Clinical Medicine in Practice 2024;28(19):109-113
- CountryChina
- Language:Chinese
- Abstract: Objective To analyze the impact of controlled hypotension(CH)by cerebral oxy-gen saturation(rSO2)monitoring on brain protection and cognitive function in anesthetized patients.Methods A total of 200 patients undergoing rSO2-monitored CH were enrolled.Patients were divid-ed into normal group(n=137)and postoperative neurocognitive disorder(PND)group(nt=63)based on whether they developed PND after surgery.Preoperative clinical data were collected.Univa-riate analysis was performed to identify factors influencing the occurrence of PND in rSO2-monitored CH patients.Multivariate binary logistic regression analysis was used to screen for independent risk factors.A predictive model was constructed based on the identified independent risk factors,and its predictive value was evaluated using receiver operating characteristic(ROC)curve analysis.Results Age,intr-aoperative blood loss,vascular surgery,20-minute rSO2 monitoring values,20-minute central venous pressure(C VP),history of hypertension,stroke and operative time were identified as factors affecting the occurrence of PND in rSO2-monitored CH patients(P＜0.05).Independent risk factors for PND included age＞55 years,high CVP during 20 minutes of surgery,low rSO2 monitoring values during 20 minutes and undergoing vascular surgery(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)for the predictive model was 0.855.Conclusion Clinically,the risk of PND in rSO2-monitored CH patients(age＞55 years,undergoing vascular surgery)can be reduced by controlling intraoperative CVP to minimize blood loss and by timely adjustment of treatment plans based on rSO2 monitoring results.
