Serum-neuroproteins, near-infrared spectroscopy, and cognitive outcome after beach-chair shoulder surgery: Observational cohort study analyses

• Background Cerebral hypoxia may occur during surgery but currently used cerebral oxygenation saturation (rSO2) monitors remain controversial with respect to improving clinical outcome. Novel neuroprotein biomarkers are potentially released into systemic circulation and combined with near-infrared spectroscopy (NIRS) could clarify the presence of per-operative cerebral hypoxia. We investigated changes to serum-neuroprotein concentrations post-surgically, paired with NIRS and cognitive outcome, in patients operated in the beach chair position (BCP). Methods A prospective cohort in 28 shoulder surgery patients placed in the BCP. Blood samples were collected before induction of anaesthesia, and 2 hours and 3-5 days post-operatively. We analysed blood levels of biomarkers including tau and neurofilament light (NFL). Wepost hocassessed the cross-wise relationship between biomarker levels and post-surgical changes in cognitive function and intraoperatively monitored rSO2 from NIRS. Results Serum-NFL decreased from 24.2 pg/mL to 21.5 (P = .02) 2 hours post-operatively, then increased to 27.7 pg/mL on day 3-5 (P = .03). Conversely,s-tau increased from 0.77 pg/mL to 0.98 (2 h), then decreased to 0.81 on day 3-5 (P = .08). In 14/28 patients, episodic rSO2 below 55% occurred, and the duration < 55% was correlated to change in s-tau (P < .05). The cognitive function z-score at 1 week and 3 mo. correlated to the change in tau (P = .01), but not to NFL. Conclusion Some biomarkers were significantly changed with surgery in the beach chair position. The change was at some points associated to post-operative cognitive decline, and to intraoperative low rSO2. (237).

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

Nyckelord

beach chair position

cerebral hypoxia

near-infrared spectroscopy

neurofilament light chain

post-operative cognitive dysfunction

tau

protein

brain-injury

cerebrospinal-fluid

blood biomarkers

total tau

anesthesia

position

disease

stroke

csf

Anesthesiology

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)