摘要 : Objectives: The aim of this study was to evaluate the prognostic impact of cerebral regional oxygen saturation (crSO(2)) in patients undergoing surgery for Stanford type A aortic dissection (TAAD). Design: Observational, retrospec... 展开 Objectives: The aim of this study was to evaluate the prognostic impact of cerebral regional oxygen saturation (crSO(2)) in patients undergoing surgery for Stanford type A aortic dissection (TAAD). Design: Observational, retrospective, institutional study. Setting: University hospital. Participants: A total of 152 patients who underwent surgery for TAAD from June 2009 to December 2018 at the authors' institution. Interventions: Surgery for TAAD using continuous perioperative monitoring of crSO(2) with near-infrared cerebral oximetry (INVOS, Medtronic, MN). Measurements and Results: The rates of postoperative stroke/global brain ischemia were 22.4% and of hospital mortality 14.5%. Age, hemoglobin, and cardiogenic shock were independent predictors of nadir crSO(2) from both frontal areas at arrival to the operating room. Repeated measures test showed that changes in crSO(2) between the first measurement at operating room arrival, at the start of surgery, and at the end of surgery were not significant when measured on the right frontal area (p = 0.632), left frontal area (p = 0.608), as a nadir value from both frontal areas (p = 0.690), and as a difference between frontal areas (p = 0.826) in patients with and without major neurologic complications. Patients who had a nadir crSO(2) <40% anytime during the perioperative period, had a numerically higher rate of major neurologic complications (27.3% v 20.4%, p = 0.354), but this difference did not reach statistical significance. The incidence of nadir of crSO(2) value <40% at operating room arrival (5.9%, p = 1.000), at the start of surgery (5.3%, p = 0.685), and at the end of surgery (1.3%, p = 1.000) was rather low and not associated with these adverse events. Conclusions: Derangements in crSO(2) detected by cerebral oximetry before and during surgery for TAAD did not predict postoperative stroke and/or global brain ischemia. (C) 2020 Elsevier Inc. All rights reserved. 收起