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British Journal of Anaesthesia 2009 103(6):811-816; doi:10.1093/bja/aep309
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© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Reduced cerebral oxygen saturation measured by absolute cerebral oximetry during thoracic surgery correlates with postoperative complications

R. Kazan, D. Bracco and T. M. Hemmerling*

ITAG (Intelligent Technology in Anaesthesia Group), Department of Anaesthesiology, Montreal General Hospital, McGill University, 1650 Cedar Avenue, Montreal, Canada H3G 1B7

* Corresponding author. E-mail: thomashemmerling{at}hotmail.com

Background: Regional cerebral oxygen saturation (SctO2) has recently been shown to decrease significantly during thoracic surgery. The present study investigates whether these desaturations are related to postoperative complications.

Methods: Fifty patients undergoing thoracic surgery with a single-lung ventilation (SLV) of >45 min duration were enrolled. Regional cerebral oxygen saturation was measured using absolute oximetry; standard clinical variables, and SOFA and Clavien scores were recorded. Correlation between minimum SctO2 during SLV and postoperative complication scores was analysed using Pearson's correlation test, {chi}2 test, and logistic regression.

Results: Forty-seven patients underwent lobectomy, two patients a pneumonectomy and 1 patient a chest wall resection. Eighty-two per cent of the patients had a decrease in SctO2 of >15% from baseline value, and 10% of the patients had a minimal absolute SctO2 value between 45% and 55%. The minimal absolute SctO2 values during SLV correlated with the Clavien score (R2=0.098, P=0.0201) and the non-respiratory SOFA score (R2=0.090, P=0.0287). By defining a threshold of SctO2=65%, the odds ratio of having a non-respiratory organ failure was 2.37 (95% CI 1.18–4.39, P=0.043) and a complication according to the Clavien score (Clavien score >0) was 3.19 (95% CI 1.60–6.34, P=0.0272).

Conclusions: Thoracic surgery with SLV seemed to be associated with a significant decrease in SctO2, and minimal SctO2 values correlated positively with postoperative complications.

Keywords: brain, cerebral saturation; surgery, thoracic; ventilation, single-lung


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Cerebral Oximetry and Single Lung Ventilation
Zach R. Fisk, M.D., M.B.A., et al.
British Journal of Anaesthesia, 11 Jan 2010 [Full text]
Absolute cerebral oximetry: Old statistics and new technology.
Antoine Bodin, et al.
British Journal of Anaesthesia, 20 Jan 2010 [Full text]

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