Journals / Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi / 2022 / Cilt: 28 - Sayı: 1
The Effect of One-Lung Ventilation on Cerebral Oxygenation and Neurocognitive Functions
- Pages
- 7–14
- DOI
- —
Abstract
Objectives: It is aimed to show the effect of one-lung ventilation (OLV) on cerebral oxygenation and neurocognitive functions. Methods: Fifty ASA I-III patients who will undergo thoracic surgery and OLV for more than 1 h were included in the prospective study. Standardized Mini-Mental State Examination (SMMSE) was applied to evaluate the pre-operative neurocognitive functions. The patients were divided into two groups as non-desaturation (n=32) and desaturation (n=18). The same test was repeated on the 3rd and 7th post-operative days. Results: Considering the mean age, ASA score, and duration of surgery and OLV of the desaturation group, it was found that the basal rSO2 values were significantly higher than the non-desaturation group. In both groups, a decrease was observed in the SMMSE values on the post-operative 3rd day, but the decreases were found to be significant on the 3rd and 7th days in the desaturation group. In the desaturation group, a statistically significant correlation was found between the percentage changes in the post-operative 3rd and 7th days according to the pre-operative SMMSE values and the percentage changes in rSO2 compared to the baseline. There was a significant positive correlation between mean arterial pressure and rSO2 in the lateral decubitus position in both groups. Conclusion: As a result, many conditions may cause cerebral desaturation in OLV; it is thought that this should be followed up closely by cerebral oximetry and thus post-operative neurocognitive dysfunction and other complications can be prevented.
Özet
Amaç: Bu çalışmada, tek akciğer ventilasyonunun serebral oksijenizasyon ve nörokognitif fonksiyonlar üzerine etkisinin gösterilmesi amaçlandı. Yöntem: Prospektif planlanan bu çalışmaya torasik cerrahi geçirecek, bir saatten uzun süre tek akciğer ventilasyonu uygulanacak ASA I-III 50 hasta dahil edildi. Preoperatif nörokognitif fonksiyonları değerlendirmek için standardize mini mental test uygulandı. Hastalar nondesatüre (n=32) ve desatüre (n=18) olmak üzere iki gruba ayrıldı. Postoperatif üçüncü ve yedinci gün aynı test tekrarlandı. Bulgular: Desatüre grubun yaş ortalaması, ASA skoru, cerrahi ve tek akciğer ventilasyonu süresi nondesatüre gruptan istatistiksel olarak anlamlı derecede yüksek, bazal rSO2 değerleri ise düşük bulundu (p