Delirium symptoms’ development during the intensive care unit post-surgery staying is related with reduced intraoperative cerebral oxygen saturation in the elderly subjected to cardiac surgery

Goal of study Our aim was to examine whether cerebral frontal cortex O 2 desaturation may be related with the development of delirium symptoms’ after cardiac surgery in the elderly during the intensive care unit (ICU) staying. Materials and methods A prospective, before and after, longitudinal study in II-IV ASA class patients scheduled for cardiac surgery and undergoing intravenous general anesthesia with remifentanil plus propofol was done. Clinical and surgical parameters, cardiopulmonary function, intraoperative cerebral oxygen saturation (rSO 2 ) and bispectral index were continuously recorded and corrected throughout the surgery. Severity of delirium was represented as a score of the Intensive Care Delirium Screening Checklist (ICDSC) during the patients’ stay in the ICU under the assumption that higher ICDSC score indicated severe delirium. Results and discussion Patients, n  = 44, 77.3% male, aged 59.9 ± 1.9 years old, scheduled to coronary (36.4%), aortic valve replacement (18.2%), mitral valve replacement (13.6%), coronary plus valve replacement (13.6%) and others (18.2%) surgery, on pump 98.4% were enrolled. A reduction of the rSO 2 higher than 10% at the end of the surgery compared with basal values was detected in a 46.5% of the patients. Reduction of rSO 2 higher than 10% at the end of the surgery was related with significantly higher values of delirium symptoms’ development during the intensive care unit post-surgery staying (rSO 2 higher ≥ 10% 68.8 vs. rSO 2 higher  P Conclusion Delirium symptoms’ development during the intensive care unit post-surgery staying is related with reduced intraoperative cerebral oxygen saturation in the elderly subjected to cardiac surgery.