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Titolo:
Cerebral hypoperfusion in immediate postoperative period following coronary artery bypass grafting, heart valve, and abdominal aortic surgery
Autore:
Millar, SM; Alston, RP; Andrews, PJD; Souter, MJ;
Indirizzi:
Univ Edinburgh, Anaesthesia Crit Care & Pain Med Sect, Dept Clin & Sug Sci, Edinburgh, Midlothian, Scotland Univ Edinburgh Edinburgh Midlothian Scotland burgh, Midlothian, Scotland Alfred Hosp, Dept Anaesthesia, Melbourne, Vic, Australia Alfred Hosp Melbourne Vic Australia aesthesia, Melbourne, Vic, Australia Royal Infirm, Dept Anaesthet, Edinburgh EH3 9YW, Midlothian, Scotland Royal Infirm Edinburgh Midlothian Scotland EH3 9YW , Midlothian, Scotland Western Gen Hosp, Dept Anaesthesia, Edinburgh EH4 2XU, Midlothian, Scotland Western Gen Hosp Edinburgh Midlothian Scotland EH4 2XU dlothian, Scotland So Gen Hosp, Dept Neuroanaesthesia, Glasgow G51 4TF, Lanark, Scotland So Gen Hosp Glasgow Lanark Scotland G51 4TF gow G51 4TF, Lanark, Scotland
Titolo Testata:
BRITISH JOURNAL OF ANAESTHESIA
fascicolo: 2, volume: 87, anno: 2001,
pagine: 229 - 236
SICI:
0007-0912(200108)87:2<229:CHIIPP>2.0.ZU;2-C
Fonte:
ISI
Lingua:
ENG
Soggetto:
VENOUS OXYGEN-SATURATION; CARDIOPULMONARY BYPASS; OXYHEMOGLOBIN DESATURATION; INJURED PATIENTS; CARDIAC-SURGERY; PROPOFOL;
Keywords:
surgery, cardiopulmonary bypass; intensive care; brain, cerebral oxygenation; veins, jugular, measurement techniques oximetry; carbon dioxide; blood, lactic acid;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Alston, RP Univ Edinburgh, Anaesthesia Crit Care & Pain Med Sect, Dept Clin & Sug Sci, Edinburgh, Midlothian, Scotland Univ Edinburgh Edinburgh Midlothian Scotland othian, Scotland
Citazione:
S.M. Millar et al., "Cerebral hypoperfusion in immediate postoperative period following coronary artery bypass grafting, heart valve, and abdominal aortic surgery", BR J ANAEST, 87(2), 2001, pp. 229-236

Abstract

Perioperative levels of jugular bulb oxyhaemoglobin saturation (Sj(O2)) and lactate concentration (Lj), and postoperative duration of Sj(O2) <50% were compared between patients undergoing coronary artery bypass grafting (CABG) (n=86), heart valve (n=14) and abdominal aortic (n=16) surgery. Radial artery and jugular bulb blood samples were aspirated after induction of anaesthesia, during re-warming on cardiopulmonary bypass (CPB) (36<degrees>C), on arrival in the intensive care unit (ICU) and, subsequently, at 1, 2 and 6 h after ICU admission. Most patients having heart surgery were hypocapnicat 36 degreesC on CPB. Following CABG and heart valve surgery, many patients were hypocapnic whereas after abdominal aortic surgery, most were hypercapnic. During CPB and postoperatively, Sj(O2) and Lj were significantly correlated to Pa-CO2 and the arterial concentration of lactate (La) respectively (P<0.05). After correction for arterial carbon dioxide tension (Pa-CO2) and La, there were no significant changes in Sj(O2) or Lj on CPB. Postoperatively, having corrected for Pa-CO2, there were significant effects on Sj(O2) over all groups as a result of time from surgery (P<0.001) and its interaction with operation type (P<0.001). Following correction for La, there were no postoperative effects on Li. No significant differences (P=0.2) in duration of Sj(O2) <50% existed between patients undergoing CABG (1054 (82) min), abdominal aortic (893 (113) min) and heart valve (1073 (91) min) surgery. The lack of significant reciprocal effects on Lj combined with the frequency of hypocapnia and strong influence of Pa-CO2 on Sj(O2), suggest that Sj(O2) <50% during CPB and after cardiac surgery represents hypoperfusion as a consequence of hypocapnia rather than cerebral ischaemia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 18/09/20 alle ore 16:54:02