Jugular bulb saturation and cognitive dysfunction after cardiopulmonary bypass

Narda D. Croughwell, Mark F. Newman, James A. Blumenthal, William D. White, Julia B. Lewis, Peter E. Frasco, Lloyd R. Smith, Elizabeth A. Thyrum, Barrie J. Hurwitz, Bruce J. Leone, Randall M. Schell, Joseph G. Reves

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217 Scopus citations


Inadequate cerebral oxygenation during cardiopulmonary bypass may lead to postoperative cognitive dysfunction in patients undergoing cardiac operations. A psychological test battery was administered to 255 patients before cardiac operation and just before hospital discharge. Postoperative impairment was defined as a decline of more than one standard deviation in 20% of tests. Variables significantly (p < 0.05) associated with postoperative cognitive impairment are baseline psychometric scores, largest arterial-venous oxygen difference, and years of education. Jugular bulb hemoglobin saturation is significant if it replaces arterial-venous oxygen difference in the model. Factors correlated with jugular bulb saturation at normothermia were cerebral metabolic rate of oxygen consumption (r = -0.6; p < 0.0005), cerebr al blood flow (t = 0.4; p < 0.0,105), oxygen delivery (r = 0.4; p < 0.0005), and mean arterial pressure (r = 0.15; p < 0.05). Three measures were significantly related to desaturation at normothermia and at hypothermia as well: greater cerebral oxygen extraction, greater arterial-venous oxygen difference, and lower ratio of cerebral blood flow to arterial-venous oxygen difference. We conclude that cerebral venous desaturation occurs during cardiopulmonary bypass in 17% to 23% of people and is associated with impaired postoperative cognitive test performance.

Original languageEnglish
Pages (from-to)1702-1708
Number of pages7
JournalAnnals of Thoracic Surgery
Issue number6
StatePublished - Dec 1994

Bibliographical note

Funding Information:
This research was supported in part by grant R01-AG09663 from the National Institutes of Health.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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