Cerebral Oxygenation During Cardiac Surgery: Effect of Different Neuroprotective Strategies on Clinical Outcome

Cerebral complications after cardiac surgery are common, costly and devastating. There has been a considerable increase in mortality related to neurological injury during the past few decades among cardiac surgical patients. The etiology of cerebral injury during CPB is multi-factorial. During CPB, jugular venous bulb oxygen saturation monitoring (SjVO2) can reflect the changes in the ratio between cerebral blood flow (CBF) and cerebral metabolic rate for oxygen consumption (CMRO2) and so can allow better care of the brain during cardiac surgery. Periods of jugular bulb desaturation seem to be related to adverse neurological outcomes after cardiac surgery. Therefore, these periods deserve careful observation, extensive evaluation and perhaps some management strategies that may improve cerebral oxygen balance. So the aim of this work was to monitor brain oxygenation during open cardiac surgery by jugular bulb blood gas analysis and to protect the brain against periods of abnormal flow-metabolism coupling by some physical and pharmacological strategies. the neurological outcome was assessed in all patients to record the potential benefit of each neuroprotective strategy used