TY - JOUR
T1 - Effect of oxygen content on postoperative cognitive dysfunction in patients undergoing open-heart surgery
AU - Soenarto, Ratna
AU - Arbi, Aditya
N1 - Funding Information:
The 3rdICE on IMERI (International Conference and Exhibition on Indonesia Medical Education and Research Institute) committee supported the peer review and manuscript preparation of this article. This study has been supported in part by grant PITTA UI (Publikasi Internasional Terindeks untuk Tugas Akhir Mahasiswa Universitas Indonesia [2043/ UN2.R3.1/HKP.05.00/2018]).
Publisher Copyright:
© 2020 Journal of Natural Science, Biology and Medicine Published by Wolters Kluwer - Medknow.
PY - 2019/11
Y1 - 2019/11
N2 - Introduction: Brain's decreased oxygen delivery is proposed as a risk factor for postoperative cognitive dysfunction (POCD). This study's objective was to investigate the effect of arterial oxygen content (CaO2) on POCD in patients undergoing open-heart surgery. Subjects and Methods: Adult patients listed for elective open-heart surgery at Cipto Mangunkusumo General Hospital were enrolled. The patients' cognitive function was tested using the Rey Auditory Verbal Learning Test, trail-making test, and digit span test (forward-backward) before and 5 days after surgery. The hemoglobin level, arterial saturation (SaO2), and arterial oxygen partial pressure (PaO2) were measured at the following five time points: before induction, 10 min after the commencement of cardiopulmonary bypass (CPB), 10 min after the cessation of CPB, 6 h postoperatively, and 1 day postoperatively. The CaO2 was calculated as follows: CaO2= 1.36 × hemoglobin × SaO2 + 0.003 × PaO2. Data were compared using Student's t-test or the Mann-Whitney test with SPSS software version 20.0 (IBM Corp., Armonk, NY, USA). Results: POCD was found in nine patients (47.4%). The CaO was significantly lower in patients with POCD than those without POCD at 10 min after the cessation of CPB (12.1 ± 2.6 vs. 14.5 ± 1.7, respectively; P = 0.03). The hemoglobin level appeared to be the cause of the decreased CaO2 in the POCD group (8.5 ± 2.3 vs. 10.2 ± 1.2, P = 0.06). Decreased oxygen content after CPB cessation may impair brain tissue oxygenation that causes POCD. Conclusion: Hemoglobin level may play an important role in POCD development after open-heart surgery.
AB - Introduction: Brain's decreased oxygen delivery is proposed as a risk factor for postoperative cognitive dysfunction (POCD). This study's objective was to investigate the effect of arterial oxygen content (CaO2) on POCD in patients undergoing open-heart surgery. Subjects and Methods: Adult patients listed for elective open-heart surgery at Cipto Mangunkusumo General Hospital were enrolled. The patients' cognitive function was tested using the Rey Auditory Verbal Learning Test, trail-making test, and digit span test (forward-backward) before and 5 days after surgery. The hemoglobin level, arterial saturation (SaO2), and arterial oxygen partial pressure (PaO2) were measured at the following five time points: before induction, 10 min after the commencement of cardiopulmonary bypass (CPB), 10 min after the cessation of CPB, 6 h postoperatively, and 1 day postoperatively. The CaO2 was calculated as follows: CaO2= 1.36 × hemoglobin × SaO2 + 0.003 × PaO2. Data were compared using Student's t-test or the Mann-Whitney test with SPSS software version 20.0 (IBM Corp., Armonk, NY, USA). Results: POCD was found in nine patients (47.4%). The CaO was significantly lower in patients with POCD than those without POCD at 10 min after the cessation of CPB (12.1 ± 2.6 vs. 14.5 ± 1.7, respectively; P = 0.03). The hemoglobin level appeared to be the cause of the decreased CaO2 in the POCD group (8.5 ± 2.3 vs. 10.2 ± 1.2, P = 0.06). Decreased oxygen content after CPB cessation may impair brain tissue oxygenation that causes POCD. Conclusion: Hemoglobin level may play an important role in POCD development after open-heart surgery.
KW - Hemoglobin
KW - oxygen delivery
KW - PaO
KW - postoperative cognitive dysfunction
KW - SaO
UR - http://www.scopus.com/inward/record.url?scp=85078091826&partnerID=8YFLogxK
U2 - 10.4103/jnsbm.JNSBM_28_19
DO - 10.4103/jnsbm.JNSBM_28_19
M3 - Article
AN - SCOPUS:85078091826
VL - 10
SP - S7-S10
JO - Journal of Natural Science, Biology and Medicine
JF - Journal of Natural Science, Biology and Medicine
SN - 0976-9668
IS - 3
ER -