AUTHOR=Chen Xuanling , Qin Xuewei , Wang Jing , Wang Rong , Guo Xiangyang , Yao Lan 

TITLE=Effect of cerebral oxygen saturation monitoring in patients undergoing superficial temporal anterior-middle cerebral artery anastomosis for ischemic Moyamoya disease: a prospective cohort study

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1226455

DOI=10.3389/fneur.2023.1226455

ISSN=1664-2295

ABSTRACT=<sec><title>Objective</title><p>Regional cerebral oxygen saturation (rSO<sub>2</sub>) is linked with blood pressure. This study evaluated the influence of perioperative rSO<sub>2</sub> monitoring on the prognosis of ischemic Moyamoya disease (MMD) patients undergoing anastomosis surgery.</p></sec><sec><title>Methods</title><p>In this prospective cohort, patients with unilateral ischemic MMD of Suzuki stage ≥3 were included. The decision of rSO<sub>2</sub> was made by the clinician and the patient. The rSO<sub>2</sub> group maintained intraoperative rSO<sub>2</sub> levels through the modulation of blood pressure, inhaled oxygen concentration, carbon dioxide in arterial blood, and red blood cell transfusion. The non-rSO<sub>2</sub> group used conventional anesthesia practices. Perioperative mean arterial pressure (MAP), rSO<sub>2</sub> values, neurological complications, and postoperative results were assessed.</p></sec><sec><title>Results</title><p>A total of 75 eligible patients were categorized into a rSO<sub>2</sub> monitoring group (<italic>n</italic> = 30) and a non-rSO<sub>2</sub> monitoring group (<italic>n</italic> = 45). For the rSO<sub>2</sub> group, the preoperative rSO<sub>2</sub> was significantly lower on the affected side (<italic>P</italic> &lt; 0.05). After anastomosis, this value notably increased (<italic>P</italic> = 0.01). A moderate relationship was observed between perioperative rSO<sub>2</sub> and MAP before, during, and after surgery, with correlation coefficients (<italic>r</italic>) of 0.536, 0.502, and 0.592 (<italic>P</italic> &lt; 0.05). Post-surgery MAP levels differed between the groups, with the rSO<sub>2</sub> group showing decreased levels compared to pre-surgery and the non-rOS<sub>2</sub> group displaying elevated levels. Notably, the rSO<sub>2</sub> group reported shorter hospitalizations and decreased neurological complications. Patients with a hypertension history found postoperative MAP influencing hospital stay duration.</p></sec><sec><title>Conclusion</title><p>Perioperative rSO<sub>2</sub> surveillance enhanced cerebral perfusion and minimized postoperative complications in ischemic MMD patients. Thus, rSO<sub>2</sub> monitoring is advocated for MMD patients undergoing vascular anastomosis.</p></sec>