Impact of Intraoperative Events on Cerebral Tissue Oximetry in XXXX Undergoing Cardiopulmonary Bypass.

@entity1 @entity26 @entity544
Previous studies showed that decreased cerebral saturation during cardiac surgery is related to adverse postoperative outcome. Therefore, we investigated the influence of intraoperative events on cerebral tissue saturation in @entity1 undergoing cardiac surgery with cardiopulmonary bypass (CPB). A total of 52 adult @entity1 who underwent cardiac surgery using pulsatile CPB were included in this prospective explorative study. Cerebral tissue @entity26 saturation (SctO2) was measured in both the left and right cerebral hemisphere. Intraoperative events, involving interventions performed by anesthesiologist, surgeon, and clinical perfusionist, were documented. Simultaneously, in-line hemodynamic parameters (partial @entity26 pressure, partial @entity544 pressure, hematocrit, arterial blood pressure, and CPB flow rates) were recorded. Cerebral tissue saturation was affected by anesthetic induction (p < .001), placement of the sternal retractor (p < .001), and initiation (p < .001) as well as termination of CPB (p < .001). Placement (p < .001) and removal of the aortic cross-clamp (p = .026 for left hemisphere, p = .048 for right hemisphere) led to changes in cerebral tissue saturation. In addition, when placing the aortic crossclamp, hematocrit (p < .001) as well as arterial (p = .007) and venous (p < .001) partial @entity26 pressures changed. Cerebral tissue oximetry effectively identifies changes related to surgical events or vulnerable periods during cardiac surgery. Future studies are needed to identify methods of mitigating periods of reduced cerebral saturation.
