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Abstract
Regional cerebral oxygen saturation (S(ct)O(2)) has recently been shown to decrease
significantly during thoracic surgery. The present study investigates whether these
desaturations are related to postoperative complications.
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 S(ct)O(2) during SLV and postoperative complication scores
was analysed using Pearson's correlation test, chi(2) test, and logistic regression.
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 S(ct)O(2)
of >15% from baseline value, and 10% of the patients had a minimal absolute S(ct)O(2)
value between 45% and 55%. The minimal absolute S(ct)O(2) values during SLV correlated
with the Clavien score (R(2)=0.098, P=0.0201) and the non-respiratory SOFA score (R(2)=0.090,
P=0.0287). By defining a threshold of S(ct)O(2)=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).
Thoracic surgery with SLV seemed to be associated with a significant decrease in S(ct)O(2),
and minimal S(ct)O(2) values correlated positively with postoperative complications.