Journals / Türk Göğüs Kalp Damar Cerrahisi Dergisi / 2017 / Cilt: 25 - Sayı: 4

The relationship of glycemic level with neurological outcomes during open cardiac surgery: A near-infrared spectroscopy study

Kalp ameliyatı sırasında nörolojik sonuçlar ile glisemik düzey arasındaki ilişki: Yakın kızılötesi spektroskopi çalışması

Pages
520–527
Publication Date
2022-09-02
DOI
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

In addition, when other variables are kept constant, changes in the blood glucose levels do not alter postoperative neurological functions.

📌 3 Key Takeaways

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Objective & Hypothesis:Background: This study aims to investigate a possible relationship between blood glucose levels and neurocognitive functions in patients undergoing cardiopulmonary bypass.Methods: Between December 2015 and February 2016, a total of 54 patients (42 males, 12 females; mean age 59.6±11.6 years; range, 31 to 83 years) undergoing elective cardiopulmonary bypass were prospectively included.
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Key Findings & Data:The patients underwent the Mini-Mental State Examination 24 h before and after the operation.
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Conclusion & Impact:In addition, when other variables are kept constant, changes in the blood glucose levels do not alter postoperative neurological functions.
🔬Design:Research Article
📍Scope:2015 Verileri
⚙️Variables:Domain Parameters

Abstract

Background: This study aims to investigate a possible relationship between blood glucose levels and neurocognitive functions in patients undergoing cardiopulmonary bypass.Methods: Between December 2015 and February 2016, a total of 54 patients (42 males, 12 females; mean age 59.6±11.6 years; range, 31 to 83 years) undergoing elective cardiopulmonary bypass were prospectively included. Preparation for surgery, anesthesia, and standard data monitoring were performed in each patient with additional regional cerebral oxygen saturation monitorization. The patients underwent the Mini-Mental State Examination 24 h before and after the operation. Cerebral oximetry and blood glucose levels were sampled at pre-defined time points (T0: before anesthesia; T1: after anesthesia; T2: after ischemia; T3: after reperfusion, and T4: after surgery).Results: No statistically significant relationship was found in the different stages of cardiopulmonary bypass between the altered cerebral oxygen saturation values and blood glucose levels. There was no significant difference between the Mini-Mental State Examination scores of the patients with respect to either presence of diabetes mellitus or timing of the test.Conclusion: Our study findings show that glycemic changes during cardiopulmonary bypass do not alter the regional cerebral oxygenation. In addition, when other variables are kept constant, changes in the blood glucose levels do not alter postoperative neurological functions.

Özet

Amaç: Bu çalışmada kardiyopulmoner baypas yapılan hastalarda kan glukoz düzeyleri ve nörobilişsel fonksiyonlar arasındaki muhtemel ilişki araştırıldı. Çalış­ma­ planı:­ Aralık 2015 - Şubat 2016 tarihleri arasında elektif kardiyopulmoner baypas uygulanan toplam 54 hasta (42 erkek, 12 kadın; ort. yaş 59.6±11.6 yıl; dağılım 31-83 yıl) prospektif olarak çalışmaya alındı. Her hasta için bölgesel serebral oksijen satürasyon monitörizasyonu ile birlikte cerrahi hazırlığı, anestezi ve standart veri takibi yapıldı. Hastalar ameliyattan 24 saat önce ve sonra Mini-Mental Durum Değerlendirmesi’ne tabi tutuldu. Serebral oksimetre ve kan glukoz düzeyleri önceden belirlenen zamanlarda örneklendi (T0: anesteziden önce; T1: anesteziden sonra;sonrası)T.2: iskemi sonrası; T3: reperfüzyon sonrası ve T4: cerrahi Bulgu­lar:­ Kardiyopulmoner baypasın farklı evrelerinde serebral oksijen satürasyon değerlerinde ve kan glukoz düzeylerinde görülen değişiklikler arasında istatistiksel olarak anlamlı bir ilişki bulunamadı. Diabetes mellitus varlığı veya testin zamanlaması açısından hastaların Mini -Mental Durum Değerlendirmesi skorları arasında da anlamlı bir fark yok idi. Sonuç:­ Çalışma bulgularımız, kardiyopulmoner baypas sırasında glisemik değişikliklerin bölgesel serebral oksijenasyonda değişikliğe neden olmadığını göstermektedir. Ayrıca, diğer değişkenler sabit tutulduğunda, kan glukoz düzeylerindeki değişiklikler ameliyat sonrası nörolojik fonksiyonları değiştirmemektedir.

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Cite This Article

ŞENER, E., ERKILIÇ, E., KESİMCİ, E., DULKADİROĞLU, T., ALAYBEYOĞLU, F., BALCI, C., KANBAK, O., GÜMÜŞ, T. (2022). The relationship of glycemic level with neurological outcomes during open cardiac surgery: A near-infrared spectroscopy study. Türk Göğüs Kalp Damar Cerrahisi Dergisi, Cilt: 25 - Sayı: 4, 520–527. https://ajindex.com/articles/423932

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References (13)

  1. Chen X, Zhao M, White PF, Li S, Tang J, Wender RH, et al. The recovery of cognitive function after general anesthesia in elderly patients: a comparison of desflurane and sevoflurane. Anesth Analg 2001
  2. Lenkin AI, Zaharov VI, Lenkin PI, Smetkin AA, Bjertnaes LJ, Kirov MY. Normothermic cardiopulmonary bypass increases cerebral tissue oxygenation during combined valve surgery: a single-centre, randomized trial. Interact Cardiovasc Thorac Surg 2013
  3. Patel N, Minhas JS, Chung EM. Risk factors associated with cognitive decline after cardiac surgery: A systematic review. Cardiovasc Psychiatry Neurol 2015
  4. 370612. 25. Ellis L, Murphy GJ, Culliford L, Dreyer L, Clayton G, Downes R, et al. The effect of patient-specific cerebral oxygenation monitoring on postoperative cognitive function: A multicenter randomized controlled trial. JMIR Res Protoc 2015
  5. Mohandas BS, Jagadeesh AM, Vikram SB. Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery. Ann Card Anaesth 2013
  6. Meng L, Gelb AW, McDonagh DL. Changes in cerebral tissue oxygen saturation during anaesthetic-induced hypotension: an interpretation based on neurovascular coupling and cerebral autoregulation. Anaesthesia 2013
  7. Miyoshi S, Morita T, Kadoi Y, Goto F. Analysis of the factors related to a decrease in jugular venous oxygen saturation in patients with diabetes mellitus during normothermic cardiopulmonary bypass. Surg Today 2005
  8. Kadoi Y, Saito S, Goto F, Fujita N. Decrease in jugular venous oxygen saturation during normothermic cardiopulmonary bypass predicts short-term postoperative neurologic dysfunction in elderly patients. J Am Coll Cardiol 2001
  9. Kadoi Y, Saito S, Yoshikawa D, Goto F, Fujita N, Kunimoto F. Increasing mean arterial blood pressure has no effect on jugular venous oxygen saturation in insulin-dependent patients during tepid cardiopulmonary bypass. Anesth Analg 2002
  10. Kawai N, Keep RF, Betz AL. Hyperglycemia and the vascular effects of cerebral ischemia. Stroke 1997
  11. Pieper GM, Meier DA, Hager SR. Endothelial dysfunction in a model of hyperglycemia and hyperinsulinemia. Am J Physiol 1995
  12. Nishikawa T, Edelstein D, Du XL, Yamagishi S, Matsumura T, Kaneda Y, et al. Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage. Nature 2000
  13. Clement S, Braithw