Objective: To evaluate the correlation between baseline cerebral oxygen saturation (ScO(2)) and cardiac function as assessed by pulmonary artery catheterization and transesophageal echocardiography (TEE).
Design: A retrospective study.
Setting: A tertiary care university hospital.
Participants: Cardiac surgery patients.
Measurements And Results: Patients undergoing cardiac surgery with bilateral recording of their baseline ScO(2) using the INVOS 4100 (Somanetics, Troy, MI) were selected. A pulmonary artery catheter was used to obtain their hemodynamic profile. Left ventricular (LV) systolic and diastolic function was evaluated by TEE, after the induction of anesthesia, using standard criteria. A model was developed to predict ScO(2). A total of 99 patients met the inclusion criteria. There were significant correlations between mean ScO(2) values and central venous pressure (CVP) (r = -0.31, p = 0.0022), pulmonary capillary wedge pressure (r = -0.25, p = 0.0129), mean pulmonary artery pressure (MPAP) (r = -0.24, p = 0.0186), mean arterial pressure/MPAP ratio (r = 0.33, p = 0.0011), LV fractional area change (<35, 35-50, and >or=50, p = 0.0002), regional wall motion score index (r = -0.27, p = 0.0062), and diastolic function (p = 0.0060). The mean ScO(2) had the highest area under the receiver operating characteristic curve (0.74; confidence interval, 0.64-0.84) to identify LV systolic dysfunction. A model predicting baseline ScO(2) was created based on LV systolic echocardiographic variables, CVP, sex, mitral valve surgery, and the use of beta-blocker (r(2) = 0.42, p < 0.001).
Conclusion: Baseline ScO(2) values are related to cardiac function and are superior to hemodynamic parameters at predicting LV dysfunction.
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http://dx.doi.org/10.1053/j.jvca.2008.02.013 | DOI Listing |
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