Regional Cerebral Oxygenation Changes Monitored with Near Infrared Spectroscopy Device During Spinal Neurosurgery in Prone Position and Postoperative Cognitive Dysfunction
Notice bibliographique
Résumé
Summary Introduction. The adverse effects of hypoxia are well known, especially regarding the brain, and can lead to postoperative cognitive disturbances. On the other hand, the brain is still one of the least monitored organs intraoperatively. Near infrared spectroscopy devices are non-invasive continuous cerebral oxygenation monitoring devices that can also be used intraoperatively. Prone position used during spinal neurosurgery is of particular importance regarding physiological changes that can occur in the human body and can lead to reduced blood and oxygen supply of the brain. Aim of the Study. The aim of the study was to determine whether prone position used during spinal neurosurgery impacts cerebral oxygenation and patients’ cognitive performance after the surgery. Material and methods. 40 patients were included in the study (32 study group, 8 control group). Patients were scheduled for spinal neurosurgery in prone position. All patients received standard general anaesthesia. In the study group regional cerebral oxygen saturation (rScO 2 ) was continuously monitored using INVOS 4100 near infrared spectroscopy device. During the surgery every 5 minutes in study and control group medium non–invasive blood pressure, heart rate, peripheral oxygen saturation, exhaled CO 2 and cerebral oxygenation measurements were fixed. We also fixed intraoperative blood loss and duration of the operation. Cognitive function was assessed in both groups using Montreal - Cognitive Assessment (MoCA) scale before surgery and two days after the surgery. Results. We didn’t observe any significant changes in our calculated medium rScO 2 intraoperative values. During induction of anaesthesia when patients were lying supine rScO 2 above the right cerebral hemisphere was rScO 2 72±9.7%, above the left cerebral hemisphere 71± 9.7%. Cerebral oxygen saturation in prone position was rScO 2 R 74±10.7% and rScO 2 L 74±10.1%. At the end of the surgery when patients were lying supine again rScO 2 R was 74±9.3% and rScO 2 L was 74±7.9%. We didn’t observe any differences in medium MoCA scores when comparing study and control group. MoCA score before surgery in the study group was 24.1±2.9 points and 24.6±4.1 points in the control group. MoCA performed 2 days after the surgery was 24.6 ±3.2 points in study group and 24.6±2.4 points in control group. Conclusions. No significant changes were observed in medium MoCA scores between patients who intraoperatively received noninvasive cerebral oxygen saturation monitoring and patients who did not receive it. Despite medium calculated MoCA scores, individually we observed postoperative cognitive function impairment for MoCA 1-2 points in 5 out of 8 patients in the control group, but in the study group only 1 patient out of 32 showed cognitive dysfunction. Intraoperative regional cerebral oxygen saturation monitoring can help to obviate cerebral desaturation that can lead to postoperative cognitive decline.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».