Balance cerebral perfusion with superficial temporal artery pressure plus jugular bulb oxyhemoglobin saturation improve neurologic outcome during thoracic aorta surgery

Abstract

Objective The aim of this study is to analyze superficial temporal artery plus jugular bulb oxyhemoglobin saturation (SjO2) monitoring during thoracic aortic procedure with regard to neurologic outcomes. Methods We performed a prospective study of patients undergoing thoracic aortic surgery. Between Sep. 2014 and Oct. 2017, 96 patients undergoing thoracic aortic procedure were recruited and divided into two group by random number table method: study group and control group. Circulatory maintenance included deep hypothermia circulatory arrest (DHCA) and selective cerebral perfusion (SCP) method during operation. Superficial temporal artery and SjO2 of patients in study group were monitored. Whereas, only SjO2 was monitored based on clinical experience of patients in control group. In order to evaluate the incidences of postoperative neurological dysfunction, the cerebral perfusion rate and blood flow rate during the surgery of patients in study group and control group were compared. Results The flow rate of SCP in the study group was significantly lower than that in the control group (P<0.05). The recovery time, extubation time and intensive care unit(ICU) residence time of the patients in the study group were significantly shorter than the time values in the control group. In addition, the incidences of permanent neurological dysfunction (PND) and transient neurological dysfunction (TND) in the study group were significantly lower than the incidences in the control group. The difference was statistically significant (P<0.05). Conclusions The application of monitoring superficial temporal artery plus SjO2 can benefit to cerebral perfusion and decrease the neurological injury. Key words: Superficial temporal artery; Jugular vein; Oxyen saturation; Deep hypothermia circulatory arrest; Cerebral protection; Thoracic aorta surgery