Jugular bulb oxyhemoglobin desaturation, S100 beta, and neurologic and cognitive outcomes after coronary artery surgery

M J A Robson, R P Alston, I J Deary, P J D Andrews, M J Souter

Research output: Contribution to journalArticlepeer-review

Abstract

We reported that a decline in cognitive performance 3 mo after coronary artery bypass grafting surgery is associated with palpable aortic atheroma, but not postoperative jugular bulb oxyhemoglobin saturation (Sjo(2)) < 50%. However, the effect of Sjo(2) on clinical neurologic findings is not known. S100 beta is a possible surrogate biochemical marker of brain injury, and we report here the scored clinical neurologic findings in 98 patients from our previous study in relation to Sjo(2), cognitive performance, aortic atheroma, and S100 beta. Patients underwent a scored neurologic examination and cognitive assessment the day before and 3 mo after coronary artery bypass grafting surgery. Intraoperatively, intermittent blood sampling was performed, and postoperatively, the area under the curve describing Sjo(2) < 50% in relation to time was calculated from continuous jugular bulb reflectance oximetry. Palpation was used to assess the ascending aorta for the presence of atheroma. The jugular bulb concentration of S100 beta was measured 6 h after completion of surgery. The neurologic score 3 mo after surgery did not correlate with either intra- or postoperative Sjo(2) (r = 0.111, P = 0.278; and r = -0.074, P = 0.467, respectively). The main determinant of neurologic score at 3 mo was the preoperative neurologic score (r(2) = 0.63, P < 0.001), whereas palpable atheroma of the ascending aorta made a small but significant contribution (r(2) = 0.034, P = 0.004). Neurologic and cognitive scores correlated before surgery (r = 0.226, P = 0.022) and at 3 me after surgery (r = 0.348, P < 0.001). A preoperative neurologic deficit of two or more had a small but significant negative effect on cognitive performance at 3 mo (standardized beta = -0.097, P = 0.018). There was a significant univariate correlation between S100 beta and the 3-mo neurologic score (r = -0.232, P < 0.05), but not a multivariate correlation (beta = -0.090, P = 0.156).

Original languageEnglish
Pages (from-to)839-845
Number of pages7
JournalAnesthesia and analgesia
Volume93
Issue number4
Publication statusPublished - Oct 2001

Keywords

  • NEURON-SPECIFIC ENOLASE
  • CARDIOPULMONARY BYPASS
  • CARDIAC-SURGERY
  • RISK-FACTORS
  • S-100 PROTEIN
  • BRAIN INJURY
  • SATURATION
  • STROKE
  • COMPLICATIONS
  • DYSFUNCTION

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