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Research Article | DOI: https://doi.org/10.31579/2639-4162/112
1 Tehran University of Medical Sciences, Amir Alam Hospital complex, Department of anesthesiology, Tehran, Iran.
2 Tehran University of Medical Sciences, Imam Khomeini Hospital complex, Department of anesthesiology, Tehran, Iran.
3Tehran University of Medical Sciences, School of medicine, Tehran, Iran.
4 Department of Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 Iran university of medical sciences, School of medicine, Tehran, Iran.
6 Islamic azad university, school of food industrial engineering, Tehran, Iran.
7 Shahid Beheshti University of Medical Sciences, Tehran, Iran
*Corresponding Author: Kianoush Saberi, Imam Khomeini Hospital Complex, Tohid Squre, Tehran, Iran.
Citation: Kianoush Saberi, Misha Seyednia, Fatemeh Abdoli, Ali Abdoli, Hossein Saberi, et al, (2023), Investigating the Relationship Between Changes in Cerebral Oximetry and Area Under the Curve with Short-Term Complications after Cardiac Surgery, J. General Medicine and Clinical Practice. 6(6); DOI:10.31579/2639-4162/112
Copyright: © 2023, Kianoush Saberi. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 04 August 2023 | Accepted: 25 August 2023 | Published: 29 August 2023
Keywords: cerebral oximetry, complications of cardiac surgery
Background: The availability of monitoring equipment is increasing today. These devices range from invasive to non-invasive. The selection of appropriate monitoring is based on their advantages, disadvantages and costs. In general, the role of non-invasive brain monitoring is expanding due to its performance accuracy as well as greater output stability. Annually, nearly half of one million patients who undergo heart surgery commonly experience neurological complications such as cognitive disorders, neuropsychological disorders, etc. In this study we aimed to investigate the relationship between short-term complications after heart surgery with cerebral oximetry changes and the space under the curve (duration of rSo2 drop) so that this monitoring may be used for heart surgery in the future.
Methods: This prospective cross-sectional study was performed on 101 patients in the cardiac surgery room of Imam Khomeini Hospital in Tehran during 2019-2020. After entering the operating room, patients underwent routine monitoring such as: NIBP, ECG, HR, Spo2, ETCo2 will be placed. Then, before induction of anesthesia, they are monitored by INVOS 5100c cerebral oximeter rSo2. Patients will be followed up for 7 days, the duration of intubation and hospitalization in the ICU and complications such as renal failure, CVA and death will be recorded for them. P-value less than 0.05 was significant.
Result: There is a significant relationship between the AUC left and IHD (P-value=0.034), CVA (P-value=0.05), multivalve surgery (P-value=0.05), CABG surgery (P-value=0.001), dissection surgery (P-value=0.009), ICU stay (left P-value=0.01, right P-value=0.005), intubation time (P-value=0.023), people who die within a week (P-value=0.036). There is a significant relationship between the amount of rSO2Left and the EF variable before the operation (P-value=0.014), stage 3 kidney failure and mortality rate after one week (P-value=0.001). the Cross lamp duration is the highest for patients whose rSO2Left was in the region of (10-20) and the lowest Cross lamp duration for patients who did not have drop in rSO2Left (P-value=0.002). There is a significant difference in pump time between people who did not have a drop in rSO2 and people who had a drop of more than 20 minutes (P-value=0.032). The cross lamp duration of patients in the first group of rSO2 has a significant relationship with the other three groups (P-value<0.001).
Conclusion: The mean level below the cerebral oximetry chart (AUC) in patients with IHD and CVA was significant. This means that the disease affects the amount of oxygenation during the operation.
In patients undergoing CABG surgery, the data recorded on the right forehead showed a lower area under the curve. Also, patients with dissection of the aorta have more significant data on the right side.
Also, the left data of patients had a significant relationship with the EF variable before surgery and this variable affects the patient's brain oxygen level.
Today, the availability of monitoring devices is expanding. These devices range from invasive to non-invasive. Choosing the right monitoring is based on their advantages, disadvantages and costs. In general, the role of non-invasive brain monitoring is expanding due to the accuracy in performance and more stable output. Every year, nearly half of one million patients who undergo heart surgery commonly experience neurological complications such as cognitive disorders, neuropsychological disorders, etc., in a quarter of them these changes remain stable and the main cause of these complications is brain tissue ischemia (2-5). Neurological complications are one of the most important complications after heart surgery, and POCD (postoperative cognitive dysfunction) is usually seen in 23-81% of these patients (28). Other complications of the central nervous system after cardiovascular surgery can be mentioned as cerebral embolism, decreased perfusion of all parts of the brain, inflammation, cerebral hyperthermia, cerebral edema, and dysfunction of the blood-brain barrier. In addition to the above, it seems that the processes that damage the CNS can also affect other vital organs of the body and lead to damage in them as well (2). Cerebral oximetry and jugular bulb oximetry are used to evaluate brain oxygenation, which jugular bulb oximetry measures jugular oxygen saturation (Sjvo2) through the vein directly and invasively. Cerebral oximetry can measure the oxygen saturation of the cerebral vessels (rSo2) even in those with a diameter of less than one mm. It can measure the oxygen saturation locally and non-invasively through infrared light that sensors are placed on the forehead and one of its most important advantages compared with jugular bulb oximetry is that cerebral oximetry can also measure rSo2 in nonpulsatile times, such as when the patient is on cardiopulmonary bypass or cardiopulmonary arrest (1). It has been shown in some studies that interventions based on cerebral oximetry monitoring have been effective in improving the outcome of patients (1).
Considering the above, in this study, we decided to investigate the relationship between short-term complications after heart surgery with changes in cerebral oximetry and the space under the curve (duration of rSo2 drop), so that perhaps this monitoring can be used for heart surgery in the future.
This is a prospective cross-sectional study on 101 eligible patients undergoing heart surgery in Imam Khomeini Hospital from March 2018 to March 2020. All patients aged 20-80 years after obtaining informed consent and meeting the entry criteria (age 20-80 years, non-emergency cardiac surgery) will be monitored by the INVOS cerebral oximetry device and their data will be entered into a questionnaire and the amount and type of complications will be evaluated during hospitalization.
Using the sample size formula plus 10
101 patients aged 20-80 underwent heart surgery at Imam Khomeini Hospital and entered this prospective cross-sectional study. After obtaining informed consent, they were examined by the INVOS cerebral oximetry device, and their data were entered into a questionnaire, and the amount and type of complications were evaluated during the hospitalization period.
The demographic information of 101 patients of this study is analyzed in Table No.1
| N (%) | ||
| Gender | Male | 64 (63.4%) |
| Female | 37 (36.6%) | |
| BMI | 18 - 25 | 44 (43.6%) |
| 25 - 30 | 57 (56.4%) | |
| Smoker | No | 83 (82.2%) |
| Yes | 18 (17.8%) | |
| Age | Mean ± SD | 52.92 ± 16.68 |
| Median (Range) | 55 (19,79) |
Table 1: demographic information of patients
In table number 2, we examine the clinical information of the patients.
| N (%) | ||
| IHD | No | 66 (65.3%) |
| Yes | 35 (34.7%) | |
| CHF | No | 76 (75.2%) |
| Yes | 25 (24.8%) | |
| CKD | No | 94 (93.1%) |
| Yes | 7 (6.9%) | |
| DM | No | 85 (84.2%) |
| Yes | 16 (15.8%) | |
| HTN | No | 57 (56.4%) |
| Yes | 44 (43.6%) | |
| CVA | No | 89 (88.1%) |
| Yes | 12 (11.9%) | |
| CABG | No | 88 (87.1%) |
| Yes | 13 (12.9%) | |
| Valve surgery | No | 60 (59.4%) |
| Yes | 41 (40.6%) | |
| CABG + Valve surgery | No | 85 (84.2%) |
| Yes | 16 (15.8%) | |
| Multivalve surgery | No | 88 (87.1%) |
| Yes | 13 (12.9%) | |
| Dissection | No | 83 (82.2%) |
| Yes | 18 (17.8%) | |
| EF | <30> | 18 (17.8%) |
| >30% | 83 (82.2%) |
Table 2: Clinical information of patients
Cerebral oximetry changes and the area under the drop time curve (rSo2) have been analyzed in Table No. 3.
| N (%) | P-value* | ||
| LEFT rSO2<30> | 0 | 39 (38.6%) | <0> |
| <10> | 29 (28.7%) | ||
| 10 – 20 | 18 (17.8%) | ||
| >20 | 15 (14.9%) | ||
| RIGHT rSO2<30> | 0 | 41 (40.6%) | |
| <10> | 30 (29.7%) | ||
| 10 – 20 | 15 (14.9%) | ||
| >20 | 15 (14.9%) | ||
| Mean ± SD | Median (Range) | ||
| LEFT AUC | 339.77 ± 331.15 | 230 (100,1930) | |
| RIGHT AUC | 383.47 ± 471.4 | 200 (100,2350) |
Table 3: Examining changes in cerebral oximetry and the area under the curve of the drop time
In table number 4, we examine the average and standard deviation of variables calculated during the operation.
| N (%) | |||
| Duration of ICU add(days) | Death in the operating room | 2 (2.0%) | |
| <3> | 35 (34.7%) | ||
| 3 – 5 | 51 (50.5%) | ||
| >5 | 13 (12.9%) | ||
| Extubation time(hrs) | Death in the operating room& Icu | 7 (6.9%) | |
| <8> | 24 (23.8%) | ||
| 8 – 24 | 56 (55.4%) | ||
| >24 | 14 (13.9%) | ||
| Mean ± SD | Median (Range) | ||
| Pomp time(min) | 148.62 ± 65.67 | 137 (20,350) | |
| Cross Clamp time(min) | 91.58 ± 36.29 | 90 (30,208) |
Table 4: Checking the mean and standard deviation of each Variable
In table number 5, we examine the complications that occurred in the first week after the operation.
| N (%) | ||
| AKI stage1 W1 | No | 87 (86.1%) |
| Yes | 14 (13.9%) | |
| AKI stage2 W1 | No | 86 (85.1%) |
| Yes | 15 (14.9%) | |
| AKI stage3 W1 | No | 93 (92.1%) |
| Yes | 8 (7.9%) | |
| Dialysis W1 | No | 99 (98.0%) |
| Yes | 2 (2.0%) | |
| Death W1 | No | 84 (83.2%) |
| Yes | 17 (16.8%) |
Table 5: Complications that occurred during the first week after the operation
In table number 6, we examine the relationship between changes in cerebral oximetry and area under the curve with demographic and clinical information of people.
| LEFT AUC | RIGHT AUC | |||||
| Mean ± SD | P-value* | Mean ± SD | P-value* | |||
| Gender | Male | 365.33 ± 360.62 | 0.358 | 387 ± 475.95 | 0.933 | |
| Female | 293.21 ± 269.21 | 377.43 ± 472.1 | ||||
| BMI | 18 - 25 | 375.19 ± 370.27 | 0.388 | 369.64 ± 453.97 | 0.81 | |
| 25 - 30 | 310.12 ± 295.68 | 395.93 ± 491.98 | ||||
| Smoker | No | 335.02 ± 303.95 | 0.802 | 380.71 ± 489.8 | 0.925 | |
| Yes | 358.5 ± 433.47 | 393.06 ± 414.55 | ||||
| IHD | No | 384.26 ± 378.31 | 0.034 | 451.47 ± 556.37 | 0.015 | |
| Yes | 249.08 ± 178.03 | 244.76 ± 140.23 | ||||
| CHF | No | 340.81 ± 350.53 | 0.962 | 417.74 ± 515.45 | 0.275 | |
| Yes | 336.7 ± 274.01 | 280.68 ± 290.6 | ||||
| CKD | No | 347.97 ± 336.94 | 0.085 | 391.07 ± 482.78 | 0.099 | |
| Yes | 186 ± 132.59 | 246.75 ± 113.88 | ||||
| DM | No | 346.09 ± 347.65 | 0.691 | 402.12 ± 508.41 | 0.429 | |
| Yes | 304.5 ± 225.43 | 284 ± 147.98 | ||||
| HTN | No | 306.09 ± 282.78 | 0.289 | 370.32 ± 463.79 | 0.759 | |
| Yes | 386.73 ± 388.51 | 404.79 ± 491 | ||||
| CVA | No | 353.38 ± 340.74 | 0.05 | 400.68 ± 490.94 | 0.009 | |
| Yes | 199.86 ± 163.2 | 213.86 ± 95.26 | ||||
| CABG | No | 351.37 ± 348.02 | 0.087 | 413.65 ± 498.08 | 0.001 | |
| Yes | 249.56 ± 119.23 | 184.3 ± 96.42 | ||||
| Valvular | No | 346.98 ± 377.02 | 0.834 | 342.51 ± 404.37 | 0.391 | |
| Yes | 331.17 ± 271.43 | 436.85 ± 548.64 | ||||
| cabg-valv | No | 350.12 ± 343.91 | 0.493 | 395.66 ± 492.12 | 0.542 | |
| Yes | 275.82 ± 240.17 | 292.78 ± 273.49 | ||||
| Multivalve | No | 309.13 ± 252.93 | 0.05 | 366.94 ± 461.47 | 0.461 | |
| Yes | 510.83 ± 596.73 | 481.18 ± 539.84 | ||||
| dissection | No | 319.57 ± 337.58 | 0.321 | 309.02 ± 317.76 | 0.009 | |
| Yes | 408.22 ± 307.42 | 641.88 ± 764.35 | ||||
| Age.c | 20 - 40 | 388.52 ± 408.77 | 0.474 | 439.76 ± 546.72 | 0.26 | |
| 40 - 60 | 282.21 ± 247.94 | 252.26 ± 163.34 | ||||
| 60 + | 317.17 ± 256.95 | 419.81 ± 537.95 | ||||
*Based on T-test
Table 6: Examining the relationship between the space under the curve and demographic information, diseases and type of operation
In Table No. 7, we examine the average AUC during the operation against the variables of operation time and complications one week after the operation.
| LEFT AUC | RIGHT AUC | |||||
| Mean ± SD | P-value* | Mean ± SD | P-value* | |||
| Duration of ICU add(days) | No | 1122 ± . | 0.01 | 1917 ± . | 0.005 | |
| <3> | 444 ± 462.5 | 426.79 ± 514.05 | ||||
| (3 - 5) | 273.95 ± 195.4 | 359.74 ± 443.38 | ||||
| >5 | 236.73 ± 111.89 | 223.83 ± 103.4 | ||||
| Extubation time(hrs) | No | 820.75 ± 656.86 | 0.023 | 1260 ± 1007.54 | 0.008 | |
| <8> | 346.84 ± 413.91 | 285.42 ± 309.62 | ||||
| (8 - 24) | 310.02 ± 261.66 | 364.7 ± 447.81 | ||||
| >24 | 274.36 ± 122.29 | 389.4 ± 445.22 | ||||
| EF | <30> | 359.93 ± 265.59 | 0.804 | 289 ± 297.91 | 0.431 | |
| >30% | 335.43 ± 345.27 | 402.97 ± 499.37 | ||||
| AKI stage1 W1 | No | 341.1 ± 340.69 | 0.933 | 399.91 ± 499.82 | 0.464 | |
| Yes | 332.33 ± 284.77 | 286.36 ± 235.79 | ||||
| AKI stage2 W1 | No | 353.09 ± 356.06 | 0.424 | 413.72 ± 501.2 | 0.176 | |
| Yes | 272.15 ± 141.89 | 204.73 ± 133.53 | ||||
| AKI stage3 W1 | No | 344.51 ± 345.37 | 0.686 | 382.47 ± 473.11 | 0.957 | |
| Yes | 291 ± 104.93 | 392 ± 488.2 | ||||
| Dialysis W1 | No | 339.51 ± 333.28 | 0.951 | 384.72 ± 474.44 | 0.843 | |
| Yes | 360 ± . | 290 ± . | ||||
| Death W1 | No | 303.63 ± 283.07 | 0.036 | 334.97 ± 391.61 | 0.048 | |
| Yes | 507.57 ± 476.05 | 618.54 ± 724.06 | ||||
*Based on T-Test
Table 7: Examining the average AUC against the variables of operation time and complications one week after the operation
In table number 8, we examine the amount of rSO2 of patients based on demographic characteristics, diseases and type of operation.
| LEFT rSO2<30> | RIGHT rSO2<30> | |||||||||||||||||
| 0 | <10> | 10 - 20 | >20 | P-value* | 0 | <10> | 10 - 20 | >20 | P-value* | |||||||||
| Gender | Male | 26 (66.7%) | 17 (58.6%) | 14 (77.8%) | 7 (46.7%) | 0.275 | 27 (65.9%) | 19 (63.3%) | 11 (73.3%) | 7 (46.7%) | 0.466 | |||||||
| Female | 13 (33.3%) | 12 (41.4%) | 4 (22.2%) | 8 (53.3%) | 14 (34.1%) | 11 (36.7%) | 4 (26.7%) | 8 (53.3%) | ||||||||||
| BMI | 18 - 25 | 17 (43.6%) | 13 (44.8%) | 5 (27.8%) | 9 (60.0%) | 0.322 | 19 (46.3%) | 13 (43.3%) | 6 (40.0%) | 6 (40.0%) | 0.963 | |||||||
| 25 - 30 | 22 (56.4%) | 16 (55.2%) | 13 (72.2%) | 6 (40.0%) | 22 (53.7%) | 17 (56.7%) | 9 (60.0%) | 9 (60.0%) | ||||||||||
| smoker | No | 34 (87.2%) | 24 (82.8%) | 12 (66.7%) | 13 (86.7%) | 0.28 | 36 (87.8%) | 26 (86.7%) | 8 (53.3%) | 13 (86.7%) | 0.018 | |||||||
| Yes | 5 (12.8%) | 5 (17.2%) | 6 (33.3%) | 2 (13.3%) | 5 (12.2%) | 4 (13.3%) | 7 (46.7%) | 2 (13.3%) | ||||||||||
| IHD | No | 28 (71.8%) | 18 (62.1%) | 13 (72.2%) | 7 (46.7%) | 0.316 | 29 (70.7%) | 19 (63.3%) | 7 (46.7%) | 11 (73.3%) | 0.346 | |||||||
| Yes | 11 (28.2%) | 11 (37.9%) | 5 (27.8%) | 8 (53.3%) | 12 (29.3%) | 11 (36.7%) | 8 (53.3%) | 4 (26.7%) | ||||||||||
| CHF | No | 33 (84.6%) | 21 (72.4%) | 14 (77.8%) | 8 (53.3%) | 0.117 | 34 (82.9%) | 20 (66.7%) | 12 (80.0%) | 10 (66.7%) | 0.353 | |||||||
| Yes | 6 (15.4%) | 8 (27.6%) | 4 (22.2%) | 7 (46.7%) | 7 (17.1%) | 10 (33.3%) | 3 (20.0%) | 5 (33.3%) | ||||||||||
| CKD | No | 38 (97.4%) | 27 (93.1%) | 17 (94.4%) | 12 (80.0%) | 0.159 | 39 (95.1%) | 28 (93.3%) | 15 (100.0%) | 12 (80.0%) | 0.147 | |||||||
| Yes | 1 (2.6%) | 2 (6.9%) | 1 (5.6%) | 3 (20.0%) | 2 (4.9%) | 2 (6.7%) | 0 (0.0%) | 3 (20.0%) | ||||||||||
| DM | No | 33 (84.6%) | 26 (89.7%) | 15 (83.3%) | 11 (73.3%) | 0.574 | 36 (87.8%) | 27 (90.0%) | 12 (80.0%) | 10 (66.7%) | 0.186 | |||||||
| Yes | 6 (15.4%) | 3 (10.3%) | 3 (16.7%) | 4 (26.7%) | 5 (12.2%) | 3 (10.0%) | 3 (20.0%) | 5 (33.3%) | ||||||||||
| HTN | No | 20 (51.3%) | 17 (58.6%) | 13 (72.2%) | 7 (46.7%) | 0.41 | 24 (58.5%) | 18 (60.0%) | 8 (53.3%) | 7 (46.7%) | 0.833 | |||||||
| Yes | 19 (48.7%) | 12 (41.4%) | 5 (27.8%) | 8 (53.3%) | 17 (41.5%) | 12 (40.0%) | 7 (46.7%) | 8 (53.3%) | ||||||||||
| CVA | No | 34 (87.2%) | 25 (86.2%) | 17 (94.4%) | 13 (86.7%) | 0.837 | 35 (85.4%) | 27 (90.0%) | 14 (93.3%) | 13 (86.7%) | 0.845 | |||||||
| Yes | 5 (12.8%) | 4 (13.8%) | 1 (5.6%) | 2 (13.3%) | 6 (14.6%) | 3 (10.0%) | 1 (6.7%) | 2 (13.3%) | ||||||||||
| CABG | No | 33 (84.6%) | 26 (89.7%) | 17 (94.4%) | 12 (80.0%) | 0.588 | 34 (82.9%) | 28 (93.3%) | 12 (80.0%) | 14 (93.3%) | 0.412 | |||||||
| Yes | 6 (15.4%) | 3 (10.3%) | 1 (5.6%) | 3 (20.0%) | 7 (17.1%) | 2 (6.7%) | 3 (20.0%) | 1 (6.7%) | ||||||||||
| valvular | No | 18 (46.2%) | 16 (55.2%) | 10 (55.6%) | 11 (73.3%) | 0.354 | 20 (48.8%) | 14 (46.7%) | 11 (73.3%) | 10 (66.7%) | 0.229 | |||||||
| Yes | 21 (53.8%) | 13 (44.8%) | 8 (44.4%) | 4 (26.7%) | 21 (51.2%) | 16 (53.3%) | 4 (26.7%) | 5 (33.3%) | ||||||||||
| cabg-valv | No | 34 (87.2%) | 23 (79.3%) | 16 (88.9%) | 12 (80.0%) | 0.735 | 36 (87.8%) | 24 (80.0%) | 12 (80.0%) | 13 (86.7%) | 0.786 | |||||||
| Yes | 5 (12.8%) | 6 (20.7%) | 2 (11.1%) | 3 (20.0%) | 5 (12.2%) | 6 (20.0%) | 3 (20.0%) | 2 (13.3%) | ||||||||||
| multivalv | No | 34 (87.2%) | 27 (93.1%) | 14 (77.8%) | 13 (86.7%) | 0.507 | 36 (87.8%) | 27 (90.0%) | 12 (80.0%) | 13 (86.7%) | 0.821 | |||||||
| Yes | 5 (12.8%) | 2 (6.9%) | 4 (22.2%) | 2 (13.3%) | 5 (12.2%) | 3 (10.0%) | 3 (20.0%) | 2 (13.3%) | ||||||||||
| dissection | No | 31 (79.5%) | 23 (79.3%) | 12 (66.7%) | 12 (80.0%) | 0.707 | 33 (80.5%) | 25 (83.3%) | 12 (80.0%) | 8 (53.3%) | 0.121 | |||||||
| Yes | 8 (20.5%) | 6 (20.7%) | 6 (33.3%) | 3 (20.0%) | 8 (19.5%) | 5 (16.7%) | 3 (20.0%) | 7 (46.7%) | ||||||||||
| Age.c | 20 - 40 | 10 (25.6%) | 4 (13.8%) | 6 (35.3%) | 4 (26.7%) | 0.564 | 10 (24.4%) | 5 (16.7%) | 2 (14.3%) | 7 (46.7%) | 0.339 | |||||||
| 40 - 60 | 11 (28.2%) | 14 (48.3%) | 5 (29.4%) | 5 (33.3%) | 13 (31.7%) | 12 (40.0%) | 5 (35.7%) | 5 (33.3%) | ||||||||||
| 60 + | 18 (46.2%) | 11 (37.9%) | 6 (35.3%) | 6 (40.0%) | 18 (43.9%) | 13 (43.3%) | 7 (50.0%) | 3 (20.0%) | ||||||||||
*P-value based on Chi-Square And fisher Exact test
In table number 9, we examine the rSO2 level of patients against the variables of operation time and complications one week after the operation.
Table 8: Examination of the rSO2 level of patients based on demographic characteristics, diseases and type of operation
| LEFT rSO2<30> | RIGHT rSO2<30> | ||||||||||||||||||
| 0 | <10> | 10 - 20 | >20 | P-value* | Pairwise comparison | 0 | <10> | 10 - 20 | >20 | P-value* | Pairwise comparison | ||||||||
| Duration of ICU add(days) | No | 1 (2.6%) | 0 (0.0%) | 0 (0.0%) | 1 (6.7%) | 0.081 | 1 (2.4%) | 0 (0.0%) | 0 (0.0%) | 1 (6.7%) | 0.124 | ||||||||
| <3> | 17 (43.6%) | 10 (34.5%) | 3 (16.7%) | 5 (33.3%) | 20 (48.8%) | 7 (23.3%) | 5 (33.3%) | 3 (20.0%) | |||||||||||
| 3 - 5 | 21 (53.8%) | 12 (41.4%) | 11 (61.1%) | 7 (46.7%) | 19 (46.3%) | 16 (53.3%) | 8 (53.3%) | 8 (53.3%) | |||||||||||
| >5 | 0 (0.0%) | 7 (24.1%) | 4 (22.2%) | 2 (13.3%) | 1 (2.4%) | 7 (23.3%) | 2 (13.3%) | 3 (20.0%) | |||||||||||
| Extubation time(hrs) | No | 2 (5.1%) | 2 (6.9%) | 1 (5.6%) | 2 (13.3%) | 0.136 | 1 (2.4%) | 3 (10.0%) | 2 (13.3%) | 1 (6.7%) | 0.005 | ||||||||
| <8> | 13 (33.3%) | 8 (27.6%) | 1 (5.6%) | 2 (13.3%) | 17 (41.5%) | 4 (13.3%) | 2 (13.3%) | 1 (6.7%) | |||||||||||
| 8 - 24 | 21 (53.8%) | 15 (51.7%) | 14 (77.8%) | 6 (40.0%) | 20 (48.8%) | 21 (70.0%) | 8 (53.3%) | 7 (46.7%) | |||||||||||
| >24 | 3 (7.7%) | 4 (13.8%) | 2 (11.1%) | 5 (33.3%) | 3 (7.3%) | 2 (6.7%) | 3 (20.0%) | 6 (40.0%) | |||||||||||
| EF W1 | <30> | 4 (10.3%) | 5 (17.2%) | 2 (11.1%) | 7 (46.7%) | 0.014 | 3 (7.3%) | 6 (20.0%) | 5 (33.3%) | 4 (26.7%) | 0.092 | ||||||||
| >30% | 35 (89.7%) | 24 (82.8%) | 16 (88.9%) | 8 (53.3%) | 38 (92.7%) | 24 (80.0%) | 10 (66.7%) | 11 (73.3%) | |||||||||||
| AKI stage1 W1 | No | 37 (94.9%) | 22 (75.9%) | 15 (83.3%) | 13 (86.7%) | 0.159 | 36 (87.8%) | 25 (83.3%) | 12 (80.0%) | 14 (93.3%) | 0.702 | ||||||||
| Yes | 2 (5.1%) | 7 (24.1%) | 3 (16.7%) | 2 (13.3%) | 5 (12.2%) | 5 (16.7%) | 3 (20.0%) | 1 (6.7%) | |||||||||||
| AKI stage2 W1 | No | 36 (92.3%) | 24 (82.8%) | 13 (72.2%) | 13 (86.7%) | 0.249 | 40 (97.6%) | 22 (73.3%) | 11 (73.3%) | 13 (86.7%) | 0.019 | ||||||||
| Yes | 3 (7.7%) | 5 (17.2%) | 5 (27.8%) | 2 (13.3%) | 1 (2.4%) | 8 (26.7%) | 4 (26.7%) | 2 (13.3%) | |||||||||||
| AKI stage3 W1 | No | 39 (100.0%) | 27 (93.1%) | 17 (94.4%) | 10 (66.7%) | 0.001 | 41 (100.0%) | 29 (96.7%) | 12 (80.0%) | 11 (73.3%) | 0.002 | ||||||||
| Yes | 0 (0.0%) | 2 (6.9%) | 1 (5.6%) | 5 (33.3%) | 0 (0.0%) | 1 (3.3%) | 3 (20.0%) | 4 (26.7%) | |||||||||||
| Dialysis W1 | No | 39 (100.0%) | 28 (96.6%) | 18 (100.0%) | 14 (93.3%) | 0.366 | 41 (100.0%) | 29 (96.7%) | 15 (100.0%) | 14 (93.3%) | 0.375 | ||||||||
| Yes | 0 (0.0%) | 1 (3.4%) | 0 (0.0%) | 1 (6.7%) | 0 (0.0%) | 1 (3.3%) | 0 (0.0%) | 1 (6.7%) | |||||||||||
| Death W1 | No | 37 (94.9%) | 26 (89.7%) | 15 (83.3%) | 6 (40.0%) | <0> | 40 (97.6%) | 26 (86.7%) | 9 (60.0%) | 9 (60.0%) | <0> | ||||||||
| Yes | 2 (5.1%) | 3 (10.3%) | 3 (16.7%) | 9 (60.0%) | 1 (2.4%) | 4 (13.3%) | 6 (40.0%) | 6 (40.0%) | |||||||||||
| Pomp time(min) | 137.64 ± 63.11 | 143.52 ± 50.24 | 156.22 ± 70.7 | 177.93 ± 86.52 | 0.214** | 127 ± 59.95 | 157.5 ± 49.95 | 159.33 ± 60.91 | 179.27 ± 94.79 | 0.032** | (1-4) | ||||||||
| Cross Clamp time(min) | 76.26 ± 26.55 | 95.03 ± 32.8 | 112.83 ± 38.87 | 99.27 ± 46.73 | 0.002** | (1-3) | 71.66 ± 25.88 | 101.33 ± 29.51 | 102.47 ± 40.4 | 115.67 ± 44.06 | <0> | (1-2,1-3,1-4) | |||||||
*P-value based On Chi-Square and Fisher Exact Test
** P-value Based on ANOVA (Bonferoni pairwise comparison)
Table 9: Examining the rSO2 level of patients against the variables of operation time and complications one week after the operation
In this study 64 (63.4%) were male and the rest were female. 44 (43.6%) of the patients are in the normal range of BMI (18-25) and the rest are in the abnormal range, and 18 (17.8%) of the patients are smokers. Of the total number of patients, 34 (34.7%) had IHD, 25 (24.8%) had CHF, 7 (6.9%) had CKD, 16 (15.8%) had DM, 44 (43.6%) had HTN, 12 (11.9%) had CVA, and 13 (12.9%) had CABG, 16 (15.8%) had CABG-Valve operation, 46 (45.5%) were treated with Valve operation, 13 (12.9%) with Multivalve operation and finally 23 (22.8%) had Dissection.
Based on the baseline rSo2 recorded by pressure self-adhesive on the left forehead, 39 (38.6%) of the patients had no drop oxygen below 30%, 29 (28.7%) of the patients had a drop oxygen below 30% for less than 10 minutes, 18 (17.8%) of the patients had a drop oxygen below 30
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