Value of target blood pressure management based on cerebral oximetry index during CPB in preventing postoperative delirium in patients with acute type A aortic dissection
10.3760/cma.j.cn131073.20231201.00503
- VernacularTitle:CPB期间COx目标导向血压管理预防急性A型主动脉夹层手术患者术后谵妄的价值
- Author:
Weiwei LI
1
;
Songqing GUO
;
Shunyan LIN
;
Xin CHEN
;
Yang ZHANG
;
Chao LUO
;
Ju GAO
Author Information
1. 徐州医科大学麻醉学院，徐州 221004
- Keywords:
Aneurysm, dissecting;
Delirium;
Postoperative complications;
Extracorporeal circulation;
Blood pressure;
Cerebral oximetry index
- From:
Chinese Journal of Anesthesiology
2024;44(5):543-547
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of target blood pressure management based on cerebral oximetry index (COx) during cardiopulmonary bypass (CPB) in preventing postoperative delirium (POD) in patients with acute type A aortic dissection (ATAAD).Methods:One hundred and fifty-seven patients with ATAAD, aged 18-64 yr, regardless of gender, were divided into 2 groups by a random number table method: traditional experience group (group C, n=81) and COx management group (group M, n=76). The mean arterial pressure in group C was maintained in the traditional range of 60-80 mmHg during CPB. In group M, the mean arterial pressure range was obtained based on the COx and maintained within this range during CPB. The primary outcome assessed was the development of delirium within 7 days after surgery. Secondary outcomes included other postoperative complications, tracheal extubation time, and duration of cardiac intensive care unit stay. Results:Compared with group C, the incidence and severity scores of POD were significantly decreased, the duration of POD was shortened, the duration of POD was shortened, the extubation time and duration of cardiac intensive care unit stay were shortened, and the incidence of postoperative cerebral infarction and acute kidney injury was decreased in group M ( P<0.05). Conclusions:Target blood pressure management based on COx during CPB is helpful in reducing the occurrence of POD and improving the prognosis of patients undergoing surgery for ATAAD.
