BACKGROUND: Diabetes mellitus (DM) is associated with the impairment of cerebral oxygenation during cardiac surgery. The aim of the present study was to investigate the effects of DM on cerebral oxygenation assessed by jugular bulb oxygen saturation (SjvO2) in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) in a prospective controlled trial. METHODS AND RESULTS: Twenty-three diabetic patients with glycosylated hemoglobin above 7.0% (DM group) and 23 non-diabetic patients (control group) undergoing OPCAB with no-touch aortic technique were included. A fiberoptic oximetry catheter was inserted into the jugular bulb. The lowest SjvO2 and the number of patients with cerebral desaturation, defined as SjvO2 less than 50% over 5 min, were recorded during coronary grafting. Three neurocognitive tests were done before surgery and at postoperative day 2 and 7. There were no differences in SjvO2 between the groups. Furthermore, the number of patients with cerebral desaturation and all neurocognitive test scores were similar between the 2 groups. None of the patients developed neurocognitive dysfunction. CONCLUSIONS: Cerebral oxygenation in diabetic patients was similar to that of non-diabetic patients and well maintained above the critical level without resulting in clinically significant postoperative neurocognitive dysfunction during OPCAB with no-touch aortic technique.
BACKGROUND:Diabetes mellitus (DM) is associated with the impairment of cerebral oxygenation during cardiac surgery. The aim of the present study was to investigate the effects of DM on cerebral oxygenation assessed by jugular bulb oxygen saturation (SjvO2) in patients undergoing off-pump coronary artery bypass graft surgery (OPCAB) in a prospective controlled trial. METHODS AND RESULTS: Twenty-three diabeticpatients with glycosylated hemoglobin above 7.0% (DM group) and 23 non-diabeticpatients (control group) undergoing OPCAB with no-touch aortic technique were included. A fiberoptic oximetry catheter was inserted into the jugular bulb. The lowest SjvO2 and the number of patients with cerebral desaturation, defined as SjvO2 less than 50% over 5 min, were recorded during coronary grafting. Three neurocognitive tests were done before surgery and at postoperative day 2 and 7. There were no differences in SjvO2 between the groups. Furthermore, the number of patients with cerebral desaturation and all neurocognitive test scores were similar between the 2 groups. None of the patients developed neurocognitive dysfunction. CONCLUSIONS: Cerebral oxygenation in diabeticpatients was similar to that of non-diabeticpatients and well maintained above the critical level without resulting in clinically significant postoperative neurocognitive dysfunction during OPCAB with no-touch aortic technique.
Authors: Danielle Greaves; Peter J Psaltis; Daniel H J Davis; Tyler J Ross; Erica S Ghezzi; Amit Lampit; Ashleigh E Smith; Hannah A D Keage Journal: J Am Heart Assoc Date: 2020-11-07 Impact factor: 6.106