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• W2335977699 abstract "BACKGROUND: The purpose of this multicenter pilot study was to: (1) determine the frequency of regional cerebral oxygen saturation (rSc o 2 ) desaturations during cardiac surgery involving cardiopulmonary bypass (CPB); (2) evaluate the accuracy of clinician-identified rSc o 2 desaturations compared with those recorded continuously during surgery by the near-infrared spectroscopy (NIRS) monitor; and (3) assess the effectiveness of an intervention algorithm for reversing rSc o 2 desaturations. METHODS: Two hundred thirty-five patients undergoing coronary artery bypass graft and/or valvular surgery were enrolled at 8 US centers in this prospective observational study. NIRS (Invos™ 5100C; Covidien) was used to monitor rSc o 2 during surgery. The frequency and magnitude of rSc o 2 decrements >20% from preanesthesia baseline were documented, and the efficacy of a standard treatment algorithm for correcting rSc o 2 was determined. The data from the NIRS monitor were downloaded at the conclusion of surgery and sent to the coordinating center where the number of clinician-identified rSc o 2 desaturation events was compared with the number detected by the NIRS monitor. RESULTS: The average rSc o 2 obtained at baseline (mean ± SD, 61% ± 11%; 99% confidence interval, 57%–65%) and during CPB (62% ± 14%; 57%–67%) was not different. However, rSc o 2 after separation from CPB (56% ± 11%; 53%–60%) was lower than measurements at baseline and during CPB ( P < 0.001). During CPB, rSc o 2 desaturations occurred in 61% (99% confidence interval, 50%–75%) of patients. The area under the curve for product of magnitude and duration of the rSc o 2 was (mean ± SD, 145.2; 384.8% × min). Clinicians identified all patients with an rSc o 2 desaturation but identified only 340 (89.5%) of the 380 total desaturation events. Of the 340 clinician-identified rSc o 2 desaturation events, 115 resolved with usual clinical care before implementation of the treatment algorithm. For the remaining 225 events, the treatment algorithm resulted in resolution of the rSc o 2 desaturation in all but 18 patients. CONCLUSIONS: This multicenter pilot study found that 50% to 75% of patients undergoing cardiac surgery experience one or more rSc o 2 desaturations during CPB. Nearly 10% of desaturation events were not identified by clinicians, suggesting that appropriate alarming systems should be adopted to alert clinicians of such events. The intervention algorithm was effective in reversing clinically identified rSc o 2 desaturations in the majority of events." @default.
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• W2335977699 date "2016-06-01" @default.
• W2335977699 modified "2023-09-27" @default.
• W2335977699 title "A Multicenter Pilot Study Assessing Regional Cerebral Oxygen Desaturation Frequency During Cardiopulmonary Bypass and Responsiveness to an Intervention Algorithm" @default.
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• W2335977699 doi "https://doi.org/10.1213/ane.0000000000001275" @default.
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