Jugular bulb saturation and cognitive dysfunction after cardiopulmonary bypass.

Published

Journal Article

Inadequate cerebral oxygenation during cardiopulmonary bypass may lead to postoperative cognitive dysfunction in patients undergoing cardiac operations. A psychological test battery was administered to 255 patients before cardiac operation and just before hospital discharge. Postoperative impairment was defined as a decline of more than one standard deviation in 20% of tests. Variables significantly (p < 0.05) associated with postoperative cognitive impairment are baseline psychometric scores, largest arterial-venous oxygen difference, and years of education. Jugular bulb hemoglobin saturation is significant if it replaces arterial-venous oxygen difference in the model. Factors correlated with jugular bulb saturation at normothermia were cerebral metabolic rate of oxygen consumption (r = -0.6; p < 0.0005), cerebral blood flow (r = 0.4; p < 0.0005), oxygen delivery (r = 0.4; p < 0.0005), and mean arterial pressure (r = 0.15; p < 0.05). Three measures were significantly related to desaturation at normothermia and at hypothermia as well: greater cerebral oxygen extraction, greater arterial-venous oxygen difference, and lower ratio of cerebral blood flow to arterial-venous oxygen difference. We conclude that cerebral venous desaturation occurs during cardiopulmonary bypass in 17% to 23% of people and is associated with impaired postoperative cognitive test performance.

Full Text

Duke Authors

Cited Authors

  • Croughwell, ND; Newman, MF; Blumenthal, JA; White, WD; Lewis, JB; Frasco, PE; Smith, LR; Thyrum, EA; Hurwitz, BJ; Leone, BJ

Published Date

  • December 1994

Published In

Volume / Issue

  • 58 / 6

Start / End Page

  • 1702 - 1708

PubMed ID

  • 7979740

Pubmed Central ID

  • 7979740

International Standard Serial Number (ISSN)

  • 0003-4975

Digital Object Identifier (DOI)

  • 10.1016/0003-4975(94)91666-7

Language

  • eng

Conference Location

  • Netherlands