Title of the PhD Thesis: Analysis of the impact of cerebral tissue saturation on postoperative cognitive function after carotid endarterectomy and related outcomes associated with diabetes mellitus
Sándor Ágnes Dóra
Elméleti és Transzlációs Orvostudományok
Dr. Kellermayer Miklós
Sebészeti, Transzplantációs és Gasztroenterológiai Klinika, Dollinger terem
2026-08-31 13:00:00
Szív és érrendszeri betegségek élettana és klinikuma
Dr. Merkely Béla
Dr. Székely Andrea
Dr. Tin Dat Nguyen
Dr. Balogh Ádám László
Dr. Szijártó Attila
Dr. Dósa Edit
Dr. Végh Tamás
The aim of this research was to investigate the impact of cerebral tissue saturation and its change during the cross-clamp period on the patients’ cognitive status. Cognitive function did not receive much interest, however, in the past few years it has gained more and more attention. So far, the evaluation of cognitive function, as well as preservation of cognitive skills, has not been in the focus of perioperative assessment and management. In our aging population, the relevance of mental health is getting more emphasis. With the decreasing rates of complications, we can contribute to the success of a carotid surgery, that is, the maintenance and ideally the improvement of cognitive status.
In this thesis, I have explained the connection between cerebral tissue saturation measured via NIRS and postoperative cognitive function assessed with the MoCA test. As the change in rSO2 has a more determining role in the trend of postoperative mental status, preventing a significant drop in cerebral tissue saturation has an emphasized role during the intervention. In a subanalysis, the lowest cerebral tissue saturation values showed a significant association with the occurrence of long-term complications.
These results confirm the usefulness of NIRS monitoring during carotid surgeries, the need for neuromonitoring during these surgeries, and the eligibility of the MoCA test for assessing cognitive function in the perioperative period.
The increasing number of diabetic patients raised the necessity of our second research question, analyzing diabetic patients with respect to postoperative cognitive status, survival, and intraoperative trends of hemodynamic and cerebral parameters. The elevated risk for worse outcomes (higher risk for mortality and MACCE) and lower postoperative cognitive performance strengthened the relevance of the third point, the relevance of the change of physiologic parameters. The aim was to investigate the physiologic changes characteristic of this comorbidity in order to achieve a more professional management, thereby improving the outcomes of the affected patients. Diabetic patients proved to be more sensitive to anesthesiological and surgical stress, so in their cases the role of thorough preoperative assessment, as well as careful management and neuromonitoring must be highlighted.
