Mathematical model for describing cerebral oxygen desaturation in patients undergoing deep hypothermic circulatory arrest.

British Journal of Anaesthesia
G W FischerD L Reich

Abstract

Surgical treatment for aortic arch disease requiring periods of circulatory arrest is associated with a spectrum of neurological sequelae. Cerebral oximetry can non-invasively monitor patients for cerebral ischaemia even during periods of circulatory arrest. We hypothesized that cerebral desaturation during circulatory arrest could be described by a mathematical relationship that is time-dependent. Cerebral desaturation curves obtained from 36 patients undergoing aortic surgery with deep hypothermic circulatory arrest (DHCA) were used to create a non-linear mixed model. The model assumes that the rate of oxygen decline is greatest at the beginning before steadily transitioning to a constant. Leave-one-out cross-validation and jackknife methods were used to evaluate the validity of the predictive model. The average rate of cerebral desaturation during DHCA can be described as: Sct(o(2))[t]=81.4-(11.53+0.37 x t) (1-0.88 x exp (-0.17 x t)). Higher starting Sct(o(2)) values and taller patient height were also associated with a greater decline rate of Sct(o(2)). Additionally, a predictive model was derived after the functional form of a x log (b+c x delta), where delta is the degree of Sct(o(2)) decline after 15 min of DHCA. The mod...Continue Reading

References

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Citations

Oct 19, 2011·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Martin Smith
Feb 21, 2013·The Journal of Thoracic and Cardiovascular Surgery·Randall B Griepp, Gabriele Di Luozzo
Jul 20, 2016·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Hilary P GrocottMike Moon
Jun 21, 2013·Seminars in Cardiothoracic and Vascular Anesthesia·Keso Skhirtladze-Dworschak, Martin Dworschak
Sep 11, 2010·Current Opinion in Anaesthesiology·David HightonMartin Smith
Nov 13, 2012·Anesthesia and Analgesia·Arnab GhoshMartin Smith
May 23, 2020·Asian Cardiovascular & Thoracic Annals·Xiaoying Lou, Edward P Chen
Apr 5, 2019·European Journal of Anaesthesiology·Ronald A Kahn, Anelechi Anyanwu
Jul 8, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Stefan Schraag

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