{"title":"婴儿心脏手术期间优化区域脑氧饱和度对术后谵妄发生率的影响:一项回顾性研究。","authors":"Jian-Feng Liu, Si-Jia Zhou, Xiu-Hua Chen, Hua Cao, Qiang Chen","doi":"10.5761/atcs.oa.23-00057","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of optimizing regional cerebral oxygen saturation (rScO<sub>2</sub>) on the incidence of postoperative delirium and surgical outcome in infants with congenital heart disease.</p><p><strong>Methods: </strong>Sixty-one infants experienced desaturation in rScO<sub>2</sub> of 10% from baseline for more than 30 seconds during surgery between January 2020 and January 2022. Among them, 32 cases (Group A) received the corresponding treatment in the process of desaturation and 29 cases (Group B) were observed without receiving any treatment. General information, cerebral oxygen saturation, the incidence of postoperative delirium, and other relevant clinical data were collected.</p><p><strong>Results: </strong>The duration and severity of intraoperative rScO<sub>2</sub> desaturation in Group A were significantly lower than those in Group B. The incidence of postoperative delirium in Group A was significantly lower than that in Group B. There was no significant difference in the positive screening score for delirium between the two groups. Binary logistic regression analysis showed that the aortic cross-clamp time, mechanical ventilation duration, and severity of intraoperative rScO<sub>2</sub> desaturation were significantly correlated with the occurrence of postoperative delirium.</p><p><strong>Conclusion: </strong>Aggressive rScO<sub>2</sub> desaturation treatment is associated with a lower incidence of postoperative delirium and improved surgical outcomes.</p>","PeriodicalId":8037,"journal":{"name":"Annals of Thoracic and Cardiovascular Surgery","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851446/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of Optimizing Regional Cerebral Oxygen Saturation during Infant Cardiac Surgery on the Incidence of Postoperative Delirium: A Retrospective Study.\",\"authors\":\"Jian-Feng Liu, Si-Jia Zhou, Xiu-Hua Chen, Hua Cao, Qiang Chen\",\"doi\":\"10.5761/atcs.oa.23-00057\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the effect of optimizing regional cerebral oxygen saturation (rScO<sub>2</sub>) on the incidence of postoperative delirium and surgical outcome in infants with congenital heart disease.</p><p><strong>Methods: </strong>Sixty-one infants experienced desaturation in rScO<sub>2</sub> of 10% from baseline for more than 30 seconds during surgery between January 2020 and January 2022. Among them, 32 cases (Group A) received the corresponding treatment in the process of desaturation and 29 cases (Group B) were observed without receiving any treatment. General information, cerebral oxygen saturation, the incidence of postoperative delirium, and other relevant clinical data were collected.</p><p><strong>Results: </strong>The duration and severity of intraoperative rScO<sub>2</sub> desaturation in Group A were significantly lower than those in Group B. The incidence of postoperative delirium in Group A was significantly lower than that in Group B. There was no significant difference in the positive screening score for delirium between the two groups. Binary logistic regression analysis showed that the aortic cross-clamp time, mechanical ventilation duration, and severity of intraoperative rScO<sub>2</sub> desaturation were significantly correlated with the occurrence of postoperative delirium.</p><p><strong>Conclusion: </strong>Aggressive rScO<sub>2</sub> desaturation treatment is associated with a lower incidence of postoperative delirium and improved surgical outcomes.</p>\",\"PeriodicalId\":8037,\"journal\":{\"name\":\"Annals of Thoracic and Cardiovascular Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2024-01-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851446/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5761/atcs.oa.23-00057\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/7/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Thoracic and Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5761/atcs.oa.23-00057","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:研究优化区域脑氧饱和度(rScO2)对先天性心脏病婴儿术后谵妄发生率和手术结果的影响:2020年1月至2022年1月期间,有61名婴儿在手术过程中出现rScO2饱和度较基线下降10%且超过30秒的情况。其中,32 例(A 组)在血氧饱和度下降过程中接受了相应治疗,29 例(B 组)未接受任何治疗。收集了患者的一般信息、脑氧饱和度、术后谵妄发生率及其他相关临床数据:结果:A 组术中 rScO2 不饱和的持续时间和严重程度明显低于 B 组;A 组术后谵妄的发生率明显低于 B 组。二元逻辑回归分析显示,主动脉交叉钳夹时间、机械通气持续时间和术中rScO2不饱和的严重程度与术后谵妄的发生有明显相关性:结论:积极的 rScO2 饱和度降低治疗与降低术后谵妄发生率和改善手术预后有关。
Effect of Optimizing Regional Cerebral Oxygen Saturation during Infant Cardiac Surgery on the Incidence of Postoperative Delirium: A Retrospective Study.
Purpose: To investigate the effect of optimizing regional cerebral oxygen saturation (rScO2) on the incidence of postoperative delirium and surgical outcome in infants with congenital heart disease.
Methods: Sixty-one infants experienced desaturation in rScO2 of 10% from baseline for more than 30 seconds during surgery between January 2020 and January 2022. Among them, 32 cases (Group A) received the corresponding treatment in the process of desaturation and 29 cases (Group B) were observed without receiving any treatment. General information, cerebral oxygen saturation, the incidence of postoperative delirium, and other relevant clinical data were collected.
Results: The duration and severity of intraoperative rScO2 desaturation in Group A were significantly lower than those in Group B. The incidence of postoperative delirium in Group A was significantly lower than that in Group B. There was no significant difference in the positive screening score for delirium between the two groups. Binary logistic regression analysis showed that the aortic cross-clamp time, mechanical ventilation duration, and severity of intraoperative rScO2 desaturation were significantly correlated with the occurrence of postoperative delirium.
Conclusion: Aggressive rScO2 desaturation treatment is associated with a lower incidence of postoperative delirium and improved surgical outcomes.