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Ann Thorac Surg 1999;68:1464
© 1999 The Society of Thoracic Surgeons

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Supplement: Outcomes ’99: Scientific Abstracts

Frontal lobe dysfunction following cardiac surgery is associated with cerebral oxygen desaturation

^a Weill Medical College of Cornell University, New York, New York, USA

Background: Jugular venous oxygen desaturation is associated with neuropsychological dysfunction following cardiac surgery. This study is to evaluate the correlation between cerebral oxygen saturation and frontal lobe dysfunction following cardiac surgery.

Methods: With Institutional Review Board approval and informed consent, 73 patients undergoing cardiac surgery were continuously monitored with near-infrared cerebral oximeter, from prior to induction of anesthesia to the end of surgery. Antisaccadic eye movement test was performed preoperatively and 4 to 5 days after surgery. Antisaccades are eye movements deliberately made in the direction opposite to that of a suddenly presented peripheral stimulus. Antisaccades provide a simple, sensitive, and objective clinical measure of frontal lobe injury. Statistical analysis was performed with ANOVA and Bonferroni t-test. A p value < 0.5 was considered significant.

Results: The control values of frontal cerebral oxygen saturation were 60.6 ± 9.9 (mean ± standard deviation). Thirty-five patients with frontal oxygen saturation (rSO₂) < 40% had significantly higher antisaccade changes than 38 patients with rSO₂ > 40% (5.9 ± 4.9% vs 25.1 ± 7.2%, p = 0.029). Twelve patients with > 30% changes of postoperative antisaccades had significantly larger area of rSO₂ < 40% than 61 patients with < 30% changes of postoperative antisaccades (104.6 ± 36.8 min % vs 664.7 ± 272.9 min %, p = <0.001).

Conclusions: We demonstrated that cerebral oxygen saturation less than 40% was associated with frontal lobe dysfunction. Therefore, it is prudent to maintain cerebral oxygen saturation more than 40% during cardiac surgery [1–3].

References

1. Ann Thorac Surg 1994;58:1702–8.
2. Anesth Analg 1993;85:SCA13.
3. Arch Neurol 1991;48:644–68.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yao, F.S.F. Articles by Hartman, G.S. Search for Related Content PubMed Articles by Yao, F.S.F. Articles by Hartman, G.S.