The Association of Cerebral Desaturation During One-Lung Ventilation and Postoperative Recovery: A Prospective Observational Cohort Study

Monique L. Roberts, Hung Mo Lin, Elizabeth Tinuoye, Edmond Cohen, Raja M. Flores, Gregory W. Fischer, Menachem M. Weiner

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objectives: This study was designed to investigate whether cerebral oxygen desaturations during thoracic surgery are predictive of patients’ quality of recovery. As a secondary aim, the authors investigated the relationship among cerebral desaturations and postoperative delirium and hospital length of stay. Design: This study was a prospective observational cohort study. Setting: A single tertiary-care medical center from September 2012 through March 2014. Patients: Adult patients scheduled for elective pulmonary surgery requiring one-lung ventilation. Interventions: All patients were monitored with the ForeSight cerebral oximeter. Measurements and Main Results: The primary assessment tool was the Postoperative Quality of Recovery Scale. Delirium was assessed using the Confusion Assessment Method. Of the 117 patients analyzed in the study, 60 of the patients desaturated below a cerebral oximetry level of 65% for a minimum of 3 minutes (51.3%). Patients who desaturated were significantly less likely to have cognitive recovery in the immediate postoperative period (p = 0.012), which did not persist in the postoperative period beyond day 0. Patients who desaturated also were more likely to have delirium (p = 0.048, odds ratio 2.81 [95% CI 1.01-7.79]) and longer length of stay (relative duration 1.35, 95% CI 1.05-1.73; p = 0.020). Conclusions: Intraoperative cerebral oxygen desaturations, frequent during one-lung ventilation, are associated significantly with worse early cognitive recovery, high risk of postoperative delirium, and prolonged length of stay. Large interventional studies on cerebral oximetry in the thoracic operating room are warranted.

Original languageEnglish
Pages (from-to)542-550
Number of pages9
JournalJournal of Cardiothoracic and Vascular Anesthesia
Volume35
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • cerebral oximetry
  • near-infrared spectroscopy
  • one-lung ventilation
  • postoperative recovery

Fingerprint

Dive into the research topics of 'The Association of Cerebral Desaturation During One-Lung Ventilation and Postoperative Recovery: A Prospective Observational Cohort Study'. Together they form a unique fingerprint.

Cite this