Academic Journal
Jugular Venous Oxygen and Lactate Parameters for Predicting Early Cognitive Dysfunction after Off-Pump Coronary Artery Bypass Grafting: A Prospective Observational Study
| Title: | Jugular Venous Oxygen and Lactate Parameters for Predicting Early Cognitive Dysfunction after Off-Pump Coronary Artery Bypass Grafting: A Prospective Observational Study |
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| Authors: | Pooja Singh, Ramees A Anchukandan, Sunaina T Karna, Yogesh Niwariya, Vaishali Waindeskar, Harish Kumar, SRAN Bhushanam Padala, Molli Kiran |
| Source: | Annals of Indian Academy of Neurology, Vol 28, Iss 1, Pp 79-86 (2025) |
| Publisher Information: | Wolters Kluwer Medknow Publications, 2025. |
| Publication Year: | 2025 |
| Collection: | LCC:Neurology. Diseases of the nervous system |
| Subject Terms: | postoperative delirium, postoperative cognitive dysfunction, off-pump coronary artery bypass grafting, jugulo-venous oxygen indices, jugulo-venous lactate indices, Neurology. Diseases of the nervous system, RC346-429 |
| More Details: | Background and Objectives: The quality of life may be negatively impacted by postoperative cognitive dysfunction (POCD) following off-pump coronary artery bypass grafting (OPCAB). It is still unclear how useful the jugular venous lactate and oxygen parameters are in predicting POCD following OPCAB. Methods: This prospective observational study was conducted over a period of 15 months and included 54 individuals. It sought to determine the sensitivity and specificity of jugular venous lactate and oxygen parameters for early POCD prediction in patients undergoing OPCAB. Neuropsychological tests were conducted to assess baseline cognitive function. Under ultrasound guidance, the jugular bulb was cannulated. The jugular venous lactate and oxygen parameters were measured at the time of surgery, following each graft, and 6 and 24 h later. Confusion assessment method-intensive care unit score was assessed on the third postoperative day for postoperative delirium (POD). POCD was defined as a composite Z score ≥1.96 or two Z scores in individual tests at 1 week. The jugular venous lactate and oxygen parameters of the Decline (D) group were compared to those of the Normal (N) group. Receiver operating characteristic curves were used to assess the diagnostic efficacy of derived variables. Results: The incidence of POD and POCD was 18.5% and 11.1%, respectively. At T3, all derived variables showed a significant increase, although the arterio-jugular venous lactate difference (AJDL) and modified lactate oxygen index (mLOI) were substantially greater at T3 in group D compared to group N. When predicting POCD, mLOI demonstrated the highest sensitivity at 72.22%, while AJDL showed the highest specificity at 90.7%. Conclusions: For prediction of early POCD in patients undergoing elective OPCAB, mLOI had highest sensitivity, while AJDL had high specificity. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 0972-2327 1998-3549 |
| Relation: | https://journals.lww.com/10.4103/aian.aian_584_24; https://doaj.org/toc/0972-2327; https://doaj.org/toc/1998-3549 |
| DOI: | 10.4103/aian.aian_584_24 |
| Access URL: | https://doaj.org/article/cc4849297f694e97bff673b81fa5e7de |
| Accession Number: | edsdoj.4849297f694e97bff673b81fa5e7de |
| Database: | Directory of Open Access Journals |
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| ISSN: | 09722327 19983549 |
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| DOI: | 10.4103/aian.aian_584_24 |
| Published in: | Annals of Indian Academy of Neurology |
| Language: | English |