Author/Authors :
jabbour, khalil saint joseph university - hôtel dieu de france university hospital, faculty of medicine - department of anesthesiology, critical care unit, Beirut, lebanon , tohme, joanna saint joseph university - hôtel-dieu de france university hospital, faculty of medicine - department of anesthesiology, critical care unit, Beirut, lebanon , haddad, fadia saint joseph university - hôtel-dieu de france university hospital, faculty of medicine - department of anesthesiology, critical care unit, Beirut, Lebanon , hayek, gemma saint joseph university - hôtel- dieu de france university hospital, faculty of medicine - department of anesthesiology, critical care unit, Beirut, Lebanon , jabbour, hisham saint joseph university - hôtel- dieu de france university hospital, faculty of medicine - department of anesthesiology, critical care unit, Beirut, Lebanon , madi-jebara, samia saint joseph university - hôtel-dieu de france university hospital, faculty of medicine - department of anesthesiology, critical care unit, Beirut, Lebanon
Abstract :
Introduction : Mixed venous oxygen saturation (SvO_2), is an invasive monitoring technique that reflects the balance between systemic oxygen transport and tissue oxygen consumption. Whereas tissue oxygen saturation (StO_2) is a noninvasive technique that allows early detection of tissue hypoperfusion. The purpose of this study is to evaluate StO_2 in patients undergoing elective coronary surgery: single cardiopulmonary bypass (CPB), and to find a correlation between StO_2 and SvO_2. Material and Methods : All patients scheduled for elective coronary surgery from May to July 2013, were included in the study. The anesthetic management and hemodynamic monitoring were the same. The following parameters: BP, HR, CI, SaO_2, SvO_2, StO_2 at the eminence thenar, Hb and ΔPCO_2 were monitored at the following times : T1: before anesthesia induction, T2 : after induction, T3 : 30 min after the beginning of CPB, T4 : after the weaning from CBP, T5 : H 12, at D1, D2 and at the occurrence of an adverse outcome such as anemia, hypotension, arrhythmia, hypoxia, fever with or without chills.Results : Forty-five patients were included in this prospective study. Forty patients had 63 events : low cardiac output, isolated hypotension, hypoxia, anemia, AFib and atrial flutter. There was no statistically significant difference in StO2 from pre-induction till up to 2 days postoperatively, except after the weaning from CPB and 12 hours postoperatively. No correlation was noted between SvO2 and StO2 during the events that occurred both during and after the operation. Conclusion : Microcirculation at the eminence thenar may be altered after CPB. This fact is reflected by the decrease in StO_2 that was noted immediately after CPB and that returned to normal 12 hours postoperatively. However, StO_2 is not correlated with SvO_2 upon the occurrence of an event during or after elective cardiac surgery. Further studies are needed to show the benefit of this noninvasive monitoring in cardiac surgery.
NaturalLanguageKeyword :
tissue oxygen saturation , mixed venous oxgygen saturation , cardiopulmonary bypass , eminence thenar
