Cardiothoracic & vascular anesthesia
The Effect of Hypotension on Cerebral Metabolism and Perfusion in Adults Undergoing Cardiopulmonary Bypass: A Prospective Cohort Study
Authors' conclusion
This study identifies oxCCO as an optical variable that is highly responsive to hypotension.
Study context
- Population
- Elective adult patients undergoing cardiac surgery on CPB74 hypotensive events
- Participants
- 45 patients
- Outcome
- Cerebral optical variables during hypotensive events on CPB
Main finding
As reported in the abstract
Decrease in oxCCO (mean ± SD) when MAP fell below 50 mm Hg
−0.55 ± 0.18 μM
Decrease in cerebral blood flow index (mean ± SD) when MAP fell below 35 mm Hg
−48% ± 20%
Decrease in tissue oxygen saturation (mean ± SD) when MAP fell below 25 mm Hg
−9% ± 5%
P < .001
Observational data: associations, not effects.
Further findings
oxCCO decreases corresponding to literature-defined cerebral blood flow lesion and functional thresholds
- Lesion threshold
- −1.10 μM
- Functional threshold
- −0.87 μM
Transition on CPB
- Mild reductions in BP and body temperature without significant cerebral blood flow changes; temperature (mean ± SD)
- 34.9 ± 0.6°C
Multiple linear regression on temperature and BP
- oxCCO reduction
- R 2 = 0.92, P < .001
- Tissue oxygen saturation
- R 2 = 0.75, P < .001
- Cerebral blood flow index
- R 2 = 0.42, P = .002
Scalp oxCCO and tissue oxygen saturation
- No significant changes during hypotensive episodes or CPB transition
Original publication
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