Is cerebrovascular autoregulation associated with outcomes after major noncardiac surgery? A prospective observational pilot study

• DOI: 10.1111/aas.13223
• Publication Date: 2018-08-07T07:33:23Z
• Authors: Alwin Chuan; Timothy G. Short; Alexander Z. Y. Peng; Shelly Y. B. Wen; Alice X. Sun; Timothy H. Ting; Anthony S. Wan; Linda Pope; Matthias Jaeger; Anders Aneman
• Keywords: Cerebral autoregulation; Clinical endpoint; Stroke

Background Studies have identified multiple risk factors for development of cognitive decline after surgery. Impaired cerebrovascular autoregulation may be a contributor to postoperative decline. Methods One hundred and forty patients admitted major elective noncardiac surgery were recruited. Near‐infrared spectroscopy was used calculate the tissue oxygenation index dynamic (TOx). The primary endpoint Day 3 recovery as assessed using Postoperative Quality Recovery Scale. secondary combined adverse event death, acute myocardial infarction, cardiac arrest, stroke, pulmonary embolism, sepsis, kidney injury at 30. Results Higher optimal TOx values, signifying impaired autoregulation, associated with worse outcomes. Patients who cognitively recovered (n = 47) had lower values (TOx opt ) than did not recover 22): 0.06 (0.24) vs 0.18 (0.16) (mean [SD]), P 0.02. suffer 102) 17): 0.09 (0.21) 0.20 (0.27), 0.04. When dichotomized having or intact based on levels, value ≥0.1 correctly 72.7% recover, OR 3.3 (1.1‐9.9) (Odds ratio, [95% CI]), 0.03. 82.4% suffered event, 4.7 (1.3‐17.2), Conclusions In older higher surgery, failure in early period 1‐month mortality morbidity.