caa a22 4500 445374446 CHVBK 20180317142958.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s00540-011-1182-8 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1182-8 Association between cerebrovascular carbon dioxide reactivity and postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus [Elektronische Daten] [Yuji Kadoi, Chikara Kawauchi, Masataka Kuroda, Kenichiro Takahashi, Shigeru Saito, Nao Fujita, Akio Mizutani] Purpose: Our intent was to identify whether cerebrovascular CO2 reactivity in diabetic patients is a risk factor for postoperative cognitive dysfunction after coronary artery bypass graft (CABG) surgery. Methods: One hundred twenty-four diabetic patients undergoing elective CABG were studied and analyzed. Diabetic patients were divided into three groups: normal CO2 reactivity group (above 5%/mmHg), medium CO2 reactivity group (between 5 and 3%/mmHg), or impaired CO2 reactivity group (below 3%/mmHg). After the induction of anesthesia and before the start of surgery, cerebrovascular CO2 reactivity was measured for all patients. Hemodynamic parameters (arterial and jugular venous blood gas values) were measured during cardiopulmonary bypass. All patients underwent a battery of neurological and neuropsychological tests the day before surgery, 7days after surgery, and 6months after surgery. Results: At 7days, the rate of cognitive dysfunction in the impaired CO2 group was higher than in the other three groups (normal, 30%; medium, 25%; impaired, 57%; *P<0.01 compared with the other groups). In contrast, at 6months postoperatively, no significant difference in the rate of cognitive dysfunction was found among the three groups. Age, hypertension, CO2 reactivity, the duration for which jugular venous oxygen saturation (SjvO2) was less than 50%, ascending aorta atherosclerosis, diabetic retinopathy, and insulin therapy were independent predictors of short-term cognitive dysfunction in diabetic patients, and HbA1c, diabetic retinopathy, and insulin therapy were independent predictors of long-term cognitive dysfunction in diabetic patients. Conclusions: We found that impaired cerebrovascular CO2 reactivity was associated with postoperative short-term cognitive dysfunction in diabetic patients. Japanese Society of Anesthesiologists, 2011 Diabetes mellitus nationallicence Cognitive dysfunction nationallicence Cerebrovascular carbon dioxide reactivity nationallicence Kadoi Yuji Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut Kawauchi Chikara Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut Kuroda Masataka Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut Takahashi Kenichiro Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut Saito Shigeru Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut Fujita Nao Department of Anesthesia, Keiyu Orthopedic Hospital and Saitama Prefectural Cardiovascular Center, Tatebayashi, Japan aut Mizutani Akio Department of Anesthesiology, Oita University Graduate School of Medicine, Oita, Japan aut Journal of Anesthesia Springer Japan 25/5(2011-10-01), 641-647 0913-8668 25:5<641 2011 25 540 https://doi.org/10.1007/s00540-011-1182-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1182-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kadoi Yuji Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut NATIONALLICENCE 700 1- Kawauchi Chikara Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut NATIONALLICENCE 700 1- Kuroda Masataka Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut NATIONALLICENCE 700 1- Takahashi Kenichiro Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut NATIONALLICENCE 700 1- Saito Shigeru Department of Anesthesiology, Graduate School of Medicine and Saitama Prefectural Cardiovascular Center, Gunma University, 3-39-22 Showa-Machi, 371-8511, Gunma, Maebashi, Japan aut NATIONALLICENCE 700 1- Fujita Nao Department of Anesthesia, Keiyu Orthopedic Hospital and Saitama Prefectural Cardiovascular Center, Tatebayashi, Japan aut NATIONALLICENCE 700 1- Mizutani Akio Department of Anesthesiology, Oita University Graduate School of Medicine, Oita, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/5(2011-10-01), 641-647 0913-8668 25:5<641 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer