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Journal of Clinical Monitoring and Computing

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03.09.2019 | Original Research

Preoperative transcranial Doppler and cerebral oximetry as predictors of delirium following valvular heart surgery: a case–control study

verfasst von: Sarah Soh, Jae-Kwang Shim, Jong-Wook Song, Nakcheoul Choi, Young-Lan Kwak

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 4/2020

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Abstract

Delirium is a frequent and serious complication after cardiac surgery with cerebral hypoperfusion as one from the key pathophysiological mechanisms. Middle cerebral artery (MCA) mean blood flow velocity (MFV) measured by transcranial Doppler has been used as a marker of cerebral perfusion, and cerebral oximetry (rSO₂) value as a marker of its adequacy. This prospective observational trial examined the predictive value of MCA MFV and rSO₂, measured immediately before induction of anesthesia, for delirium after valvular heart surgery in elderly patients. In 113 patients, delirium was evaluated for 7 days postoperatively, using the confusion assessment method for the intensive care unit. The primary endpoint was the occurrence of postoperative delirium. Overall, 16 patients (14%) exhibited delirium. MCA MVF values could not predict the development of delirium. Preoperative statin use, geriatric depression scale score, and low preoperative rSO₂ (< 60%) showed association with delirium occurrence in univariable analysis. After multivariable analysis, only the low preoperative rSO₂ (< 60%) (OR 6.748, 95% CI 1.647–27.652, P = 0.008) remained as an independent predictor of delirium. Preoperative MCA MFV was not significantly associated with delirium after valvular heart surgery in elderly patients, while a low baseline rSO₂ value was associated with a sevenfold increased risk of delirium.

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Titel: Preoperative transcranial Doppler and cerebral oximetry as predictors of delirium following valvular heart surgery: a case–control study
verfasst von: Sarah Soh
Jae-Kwang Shim
Jong-Wook Song
Nakcheoul Choi
Young-Lan Kwak
Publikationsdatum: 03.09.2019
Verlag: Springer Netherlands
Erschienen in: Journal of Clinical Monitoring and Computing / Ausgabe 4/2020
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI: https://doi.org/10.1007/s10877-019-00385-x

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Preoperative transcranial Doppler and cerebral oximetry as predictors of delirium following valvular heart surgery: a case–control study

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