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RISS 인기검색어
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- 저자 : Zafer Çukurova (검색결과 1 건)
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Guray Demir,Zafer Çukurova,Gülay Eren,Oya Hergünsel 대한마취통증의학회 2014 Korean Journal of Anesthesiology Vol.67 No.6
Background: Central nervous system complications are the most clinically important of those affecting mortality in patientsundergoing coronary artery surgery. Newly developed sophisticated techniques and surgical interventions obviatingthe need for cardiopulmonary pumps have facilitated avoidance of these complications. In this study, we comparedthe impact of on-pump and off-pump coronary artery bypass surgery on cerebral oxygenation using near-infrared spectroscopy. Methods: This study included 40 patients with no comorbidities who were scheduled for on-pump (n = 20) and offpump(n = 20) cardiac surgery. Preoperative and postoperative Standardized Mini-Mental State Examination (SMMSE)scores, perioperative mean arterial blood pressure (MAP), hematocrit (Hct), peripheral oxygen saturation (SpO2), regionalcerebral oximetry values (rSO2), body temperature, and partial pressure of carbon dioxide (PCO2) were recorded,for all patients. Intergroup and intragroup comparisons were then performed. Results: The mean operative time was longer in the on-pump group. SMMSE scores were similar and relevant postoperativevalues were lower in both groups. Perioperative MAP, PCO2, and SpO2 were similar in both groups. SpO2 and PCO2did not differ from baseline levels in either group, while the postextubation MAP at 2 h postoperatively remained low. Hct levels decreased during the perioperative and postoperative periods, while the body temperature declined perioperativelyand to a greater degree in the on-pump group. The intraoperative and postoperative rSO2 decreased in both groups. In the on-pump group, the decrease in rSO2 was more prominent during the interval between the start and closure of thesternotomy. Conclusions: Physiological alterations that occur during coronary artery surgery affect cerebral oxygenation duringand after the operation irrespective of the application of a cardiopulmonary pump. Cerebral oxygenation decreases to agreater extent during on-pump surgery; however, probably because of the neuroprotective effects of hypothermia, thepostoperative changes resemble those of off-pump surgery.
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