Baseline cerebral oximetry values in cardiac and vascular surgery patients: a prospective observational study

J Cardiothorac Surg. 2010 May 24:5:41. doi: 10.1186/1749-8090-5-41.

Abstract

Aim: This study was conducted to evaluate baseline INVOS values and identify factors influencing preoperative baseline INVOS values in carotid endarterectomy and cardiac surgery patients.

Methods: This is a prospective observational study on 157 patients (100 cardiac surgery patients, 57 carotid endarterectomy patients). Data were collected on factors potentially related to baseline INVOS values. Data were analyzed with student's t-test, Chi-square, Pearson's correlation or Linear Regression as appropriate.

Results: 100 cardiac surgery patients and 57 carotid surgery patients enrolled. Compared to cardiac surgery, carotid endarterectomy patients were older (71.05 +/- 8.69 vs. 65.72 +/- 11.04, P < 0.001), with higher baseline INVOS (P < 0.007) and greater stroke frequency (P < 0.002). Diabetes and high cholesterol were more common in cardiac surgery patients. Right side INVOS values were strongly correlated with left-side values in carotid (r = 0.772, P < 0.0001) and cardiac surgery patients (r = 0.697, P < 0.0001). Diabetes and high cholesterol were associated with significantly (P < 0.001) lower INVOS and smoking was associated with higher INVOS values in carotid, but not in cardiac surgery patients. Age, sex, CVA history, Hypertension, CAD, Asthma, carotid stenosis side and surgery side were not related to INVOS. Multivariate analysis showed that diabetes is strongly associated with lower baseline INVOS values bilaterally (P < 0.001) and explained 36.4% of observed baseline INVOS variability in carotid (but not cardiac) surgery.

Conclusion: Compared to cardiac surgery, carotid endarterectomy patients are older, with higher baseline INVOS values and greater stroke frequency. Diabetes and high cholesterol are associated with lower baseline INVOS values in carotid surgery. Right and left side INVOS values are strongly correlated in both patient groups.

MeSH terms

  • Aged
  • Brain / metabolism*
  • Cardiac Surgical Procedures / adverse effects*
  • Cerebrovascular Circulation
  • Cognition Disorders / etiology
  • Cognition Disorders / physiopathology
  • Endarterectomy, Carotid / adverse effects*
  • Humans
  • Middle Aged
  • Oximetry*
  • Risk Factors
  • Spectrum Analysis / instrumentation
  • Spectrum Analysis / methods
  • Stroke / etiology
  • Stroke / physiopathology