Cerebral oximetry values in dialyzed surgical patients: a comparison between hemodialysis and peritoneal dialysis. (July 2013)

• Record Type: Journal Article
• Authors: Papadopoulos, Georgios; Dounousi, Evangelia; Papathanasiou, Athanasios; Papathanakos, Georgios; Tzimas, Petros
• Is Part Of: Renal failure. Volume 35:Number 6(2013)
• Page Start: 855
• Page End: 859
• Publication Date: 2013-07
• Subjects: Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.3109/0886022X.2013.794675
• Languages: English
• ISSNs: 0886-022X

Abstract

<abstract> <title>Abstract</title> <p> <italic>Background</italic>: Cerebral tissue regional oxygen saturation (rSO<sub>2</sub>) through near-infrared spectroscopy (NIRS) is a method for non-invasive monitoring of cerebral tissue oxygenation. However, nowadays there is limited information on the level of cerebral tissue oxygenation in dialyzed end-stage renal disease (ESRD) surgical patients. The aim of this observational study was to evaluate the baseline cerebral rSO<sub>2</sub> values, to compare values between hemodialysis (HD) and peritoneal dialysis (PD) patients and identify risk factors that could predict cerebral tissue oxygenation in these patients. <italic>Patients/Methods</italic>: Thirty-two ESRD patients (≥18 years old), scheduled to undergo elective minor or major surgery, were enrolled. Patients were allocated in two groups according to dialysis modality. Twenty-three patients were treated with HD and nine were treated with PD. Demographic and clinical characteristics, comorbidities and arterial hemoglobin oxygen saturation (SpO<sub>2</sub>) of the study population were recorded. <italic>Results</italic>: Patients who were treated with HD had significant lower baseline rSO<sub>2</sub> values compared with PD patients [median, 50% (28–63) vs. 63% (45–69), <italic>p =</italic> 0.002]. Hierarchical linear regression model analysis showed that preoperative Hb and SpO<sub>2</sub> were positive predictive variables (<italic>B</italic> = 0.353, <italic>p =</italic> 0.01 and <italic>B</italic> = 0.375, <italic>p =</italic> 0.009, respectively) for rSO<sub>2</sub>. Moreover, dialysis modality was independent predictor for baseline rSO<sub>2</sub>. The modality of dialysis remained an independent predictor for rSO<sub>2</sub> after controlling for the other significant variables (<italic>B</italic> = 0.291, <italic>p =</italic> 0.032) and PD was associated with higher baseline values of rSO<sub>2</sub>. <italic>Conclusion</italic>: In conclusion, ESRD surgical patients undergoing PD treatment appear to have significantly higher baseline cerebral tissue saturation values compared with HD.</p> </abstract>