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Cerebral oxygen saturation (rSO2) during cardiopulmonary bypass (CPB) measured using the INVOS oximeter closely correlates with baseline rSO2

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Abstract

Baseline cerebral regional saturation (rSO2) measured using the INVOS 5100C (Medtronic, MN, USA) varies widely among patients with cardiac and/or renal diseases. To identify significant correlates of baseline rSO2 and to investigate intraoperative rSO2 changes, we conducted a retrospective study in 494 patients undergoing on-pump cardiovascular surgery. Correlations between preoperative blood laboratory test variables and baseline rSO2 before anesthesia were examined. Intraoperative rSO2 changes were analyzed. Of all the variables examined, log-transformed B-type natriuretic peptide (BNP) most significantly and negatively correlated with baseline rSO2 (r = − 0.652, p < 0.0001). Intraoperatively, rSO2 showed the lowest value during cardiopulmonary bypass (CPB) (median rSO2: 56.2% during CPB vs. 63.9% at baseline, p < 0.0001). Although rSO2 during CPB correlated positively with hemoglobin concentration and oxygen delivery during CPB (r = 0.192, p < 0.0001; and r = 0.172, p = 0.0001, respectively), it correlated much more closely with baseline rSO2 (r = − 0.589, p < 0.0001). Thus, patients showing low baseline rSO2 primarily associated with preoperatively high BNP continued to show low rSO2 even during CPB independent of hemodynamics artificially controlled by CPB. Our findings suggest that low baseline rSO2 in patients with high BNP due to cardiac and/or renal diseases is more likely to result from tissue edema causing alterations in optical pathlength and thus in calculated rSO2 values, not readily modifiable with CPB, rather than actual cerebral hemodynamic alterations readily modifiable with CPB. These may partly explain why the INVOS oximeter is a trend monitor requiring baseline measures.

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Acknowledgements

The authors thank all the medical and co-medical staff associated with cardiac surgery at Juntendo University Hospital for their assistance in conducting this study. This research received no grant from any funding agency in the public, commercial or not-for-profit sectors. The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

    Yumiko Kadokura, Masakazu Hayashida, Maho Kakemizu-Watanabe & Makiko Yamamoto

  2. Department of Cardiovascular Surgery, Graduate School of Medicine, Juntendo University, Tokyo, Japan

    Daisuke Endo, Atsumi Oishi, Keisuke Nakanishi & Hiroaki Hata

Authors
  1. Yumiko Kadokura
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  2. Masakazu Hayashida
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  3. Maho Kakemizu-Watanabe
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  4. Makiko Yamamoto
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  5. Daisuke Endo
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  6. Atsumi Oishi
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  7. Keisuke Nakanishi
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  8. Hiroaki Hata
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Yumiko Kadokura, Maho Kakemizu-Watanabe, Makiko Yamamoto, Daisuke Endo, and Atsumi Oishi. Data analysis was performed by Masakazu Hayashida and Keisuke Nakanishi. The first draft of the manuscript was written by Yumiko Kadokura, and reviewed and edited by Masakazu Hayashida and Hiroaki Hata. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Masakazu Hayashida.

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Kadokura, Y., Hayashida, M., Kakemizu-Watanabe, M. et al. Cerebral oxygen saturation (rSO2) during cardiopulmonary bypass (CPB) measured using the INVOS oximeter closely correlates with baseline rSO2. J Artif Organs 24, 433–441 (2021). https://doi.org/10.1007/s10047-021-01263-7

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  • DOI: https://doi.org/10.1007/s10047-021-01263-7

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