Acute hypervolemic hemodilution improves cognitive function and reduces plasma S100βin elderly lung cancer patients following radical surgery / 医学研究生学报

ABSTRACT

Objective Radical surgery is extensively used in the treatment of lung cancer in elderly patients .This study aimed to investigate the effects of acute hypervolemic hemodilution (AHVHD) on the cognitive function and plasma S100βof elderly people following radical surgery for lung cancer . Methods A total of 112 lung cancer patients treated by radical surgery were equally randomized to an AHVHD and a non-AHVHD control group .Using the Mini-Mental State Examination scale ( MMSE) , we evaluated the cognitive function of the patients .We made comparisons between the two groups in the cerebral oxygen metabolism indexes and plasma S100βlevels at T0(immediately after anesthesia induction), T1(15 min after hemodilution), T2(60 min after hemodilution), T3(60 min before the end of surgery ) and T4 ( at the end of surgery ) as well as MMSE scores before and after operation . Results At T1 , T2, T3, and T4, the values of jugular venous oxygen saturation in the AHVHD group were (75.1 ±4.3), (78.5 ±3.1), (79.1 ± 4.4), and (79.6 ±2.8) %, respectively, with time-dependent decreases in Da-jvO2 and cerebral oxygen extraction , and significantly higher than that at T0 (P<0.05) and those in the control group ([63.4 ±2.0], [63.9 ±1.8], [64.2 ±3.0], and [64.7 ±3.2]%) (P<0.05).The levels of plasma S100βat T1, T2, T3, and T4 were remarkably lower in the AHVHD group ([0.53 ±0.04], [0.52 ±0.07], [0.51 ±0.06], and [0.50 ±0.08] μg/L) than in the control ([0.64 ±0.06], [0.64 ±0.04], [0.65 ±0.05], and [0.67 ±0.06] μg/L), with statistically significant differences between the two groups at the same time point (P<0.05).At 1, 3, 5, and 7 days after surgery, the MMSE scores were markedly higher in the AHVHD group (24.3 ±1.7, 26.5 ±1.9, 27.8 ±1.3, and 28.1 ±1.0) than in the control (21.1 ±1.6, 24.0 ±2.1, 25.9 ±1.8, and 26.4 ±1.7) (P<0.05). Conclusion AHVHD can significantly improve cognitive function and reduce plasma S 100βin elderly patients following radical surgery for lung cancer , which may be related to cerebral oxygen metabolism .