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Published in: Trials 1/2019

Open Access 01-12-2019 | Hypotension | Research

Regional cerebral oxygen saturation and postoperative delirium in endovascular surgery: a prospective cohort study

Authors: Xiaohua Wang, Kunpeng Feng, Haixia Liu, Yanhui Liu, Ming Ye, Guoguang Zhao, Tianlong Wang

Published in: Trials | Issue 1/2019

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Abstract

Background

Delirium is an acute mental disorder and common postoperative complication. Monitoring regional cerebral oxygen saturation (rSO2) in endovascular therapeutic surgery may allow real-time monitoring of cerebral desaturation, avoiding profound cerebral dysfunction, and reducing the incidence of delirium. We sought to examine the incidence of delirium in patients undergoing endovascular surgery.

Methods

This was a clinical cohort trial (registered with http://​www.​clinicaltrials.​gov [NCT02356133]). We monitored the rSO2 of 43 patients undergoing general anesthesia and cerebral endovascular surgery. The occurrence of delirium after surgery was recorded with the Confusion Assessment Method (CAM). Multivariate logistic regression was performed to identify the main predictor of delirium.

Results

rSO2 was significantly different between the delirium and no-delirium groups. The occurrence of delirium was 35% in our cohort, and higher rSO2 desaturation scores were significantly associated with profound delirium (higher CAM score; odds ratio = 1.002; P = 0.021). The maximum declines of systolic blood pressure were 24.86 (21.78–27.93) and 32.98 (28.78–37.19) in the no-delirium and delirium groups, respectively, which were significantly different (P = 0.002) but not closely associated with delirium in multivariate analysis (P = 0.512). Anesthesia, mechanical ventilation duration, and having two vascular risk factors differed significantly between groups but were poorly associated with delirium outcome.

Conclusions

Elevated rSO2 desaturation score was predictive of the occurrence of postoperative delirium following endovascular surgery. Monitoring rSO2 is invaluable for managing controlled hypotension during endovascular surgery and reducing postoperative delirium.

Trial registration

ClinicalTrials.gov, NCT02356133. Registered 1 February 2015. All statistical analysis results submitted August 4, 2018.
Appendix
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Metadata
Title
Regional cerebral oxygen saturation and postoperative delirium in endovascular surgery: a prospective cohort study
Authors
Xiaohua Wang
Kunpeng Feng
Haixia Liu
Yanhui Liu
Ming Ye
Guoguang Zhao
Tianlong Wang
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Trials / Issue 1/2019
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-019-3586-y

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