초록접수 현황
| 14F-183 | 구연 발표 |
Does Intraoperative Non-invasive Cerebral Oxygenation Monitoring(rSO2) Predict Adverse Outcomes after Aortic Arch Surgery?
Kwan Wook Kim, Sak Lee, Young-Nam Youn, Byung-Chul Chang, Kyung-Jong Yoo, Hyun Chel Joo
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
Background : Aortic arch surgery is associated with considerable morbidity and mortality. Cerebral oximetry is a non-invasive technique that can monitor the regional oxygen saturation (rSO2) of the frontal cortex. We hypothesized that decreased intraoperative rSO2 was associated with postoperative complications.
Methods : From Jan. 2007 to Dec. 2013, 97 consecutive patients who underwent aortic arch surgery diagnosed with aortic aneurysm or dissection were enrolled in this study. The intraoperative rSO2 values were recorded during operation and two groups were divided as rSO2 decreased below 50% from initial value (group I) and above 50% from initial value (group II). Postoperative complications were categorized as ICU stay, postoperative CVA (including TIA), early & late mortality, and compared group I with group II.
Results : Group I patients were 36 and Group II patients were 61. There were no significant differences in ICU stay (4.9days vs 6.3days, p=0.29), 30days mortality (3.3% vs 8.3%, p=0.36), Late mortality (3.3% vs 5.6%, p=0.63) between the two groups. There was significant difference in postoperative CVA (1.6% vs 13.9%, p=0.03) between the two groups. The ROC curve analysis showed that rSO2 >50% decline from baseline value had the best performance (area under the curve-ROC, 0.764: 95% CI 0.559-0.933, p=0.044).
Conclusion : Decreased rSO2 value above 50% from initial rSO2 value is associated with postoperative neurologic complications after aortic arch surgery. Intraoperative rSO2 monitoring is valuable and convenient method to predict postoperative neurologic complication after aortic arch surgery.
Methods : From Jan. 2007 to Dec. 2013, 97 consecutive patients who underwent aortic arch surgery diagnosed with aortic aneurysm or dissection were enrolled in this study. The intraoperative rSO2 values were recorded during operation and two groups were divided as rSO2 decreased below 50% from initial value (group I) and above 50% from initial value (group II). Postoperative complications were categorized as ICU stay, postoperative CVA (including TIA), early & late mortality, and compared group I with group II.
Results : Group I patients were 36 and Group II patients were 61. There were no significant differences in ICU stay (4.9days vs 6.3days, p=0.29), 30days mortality (3.3% vs 8.3%, p=0.36), Late mortality (3.3% vs 5.6%, p=0.63) between the two groups. There was significant difference in postoperative CVA (1.6% vs 13.9%, p=0.03) between the two groups. The ROC curve analysis showed that rSO2 >50% decline from baseline value had the best performance (area under the curve-ROC, 0.764: 95% CI 0.559-0.933, p=0.044).
Conclusion : Decreased rSO2 value above 50% from initial rSO2 value is associated with postoperative neurologic complications after aortic arch surgery. Intraoperative rSO2 monitoring is valuable and convenient method to predict postoperative neurologic complication after aortic arch surgery.
책임저자: 주현철
연세대학교 의과대학 심장혈관병원 흉부외과학교실
연락처 : 김관욱, Tel: 02-2228-8493 , E-mail : mujin10km@yuhs.ac
