Association of Somatic Regional Oxygen Saturation With Clinical Outcomes in Neonates Following Cardiac Surgery

2021 ◽  
Vol 22 (7) ◽  
pp. e415-e416
Author(s):  
Michael C. Spaeder ◽  
Victoria J. Surma
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Clinical Outcomes ◽  
Regional Oxygen Saturation

scholarly journals Preoperative Cerebral Oxygen Saturation and Clinical Outcomes in Cardiac Surgery

2011 ◽  
Vol 114 (1) ◽  
pp. 58-69 ◽  
Author(s):  
Matthias Heringlake ◽  
Christof Garbers ◽  
Jan-Hendrik Käbler ◽  
Ingrid Anderson ◽  
Hermann Heinze ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Clinical Outcomes ◽  
Natriuretic Peptide ◽  
Troponin T ◽  
Area Under The Curve ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Mortality And Morbidity ◽  
High Sensitive Troponin

Background The current study was designed to determine the relation between preoperative cerebral oxygen saturation (Sco2), variables of cardiopulmonary function, mortality, and morbidity in a heterogeneous cohort of cardiac surgery patients. Methods In this study, 1,178 consecutive patients scheduled for on-pump surgery were prospectively studied. Preoperative Sco2, demographics, N-terminal pro-B-type natriuretic peptide, high-sensitive troponin T, clinical outcomes, and 30-day and 1-yr mortality were recorded. Results Median additive EuroSCORE was 5 (range: 0-19). Thirty-day and 1-yr mortality and major morbidity (at least two major complications and/or a high-dependency unit stay of at least 10 days) were 3.5%, 7.7%, and 13.3%, respectively. Median minimal preoperative oxygen supplemented Sco2 (Sco2min-ox) was 64% (range: 15-92%). Sco2min-ox was correlated (all: P value <0.0001) with N-terminal pro-B-type natriuretic peptide (ρ: -0.35), high-sensitive troponin T (ρ: -0.28), hematocrit (ρ: 0.34), glomerular filtration rate (ρ: 0.19), EuroSCORE (τ: 0.20), and left ventricular ejection fraction class (τ: 0.12). Thirty-day nonsurvivors had a lower Sco2min-ox than survivors (median 58% [95% CI, 50.7-62%] vs. 64% [95% CI, 64-65%]; P < 0.0001). Receiver-operating curve analysis of Sco2min-ox and 30-day mortality revealed an area-under-the-curve of 0.71 (95% CI, 0.68-0.73%; P < 0.0001) in the total cohort and an area-under-the-curve of 0.77 (95% CI, 0.69-0.86%; P < 0.0001) in patients with a EuroSCORE more than 10. Logistic regression based on different EuroSCORE categories (0-2; 3-5, 6-10, >10), Sco2min-ox, and duration of cardiopulmonary bypass showed that a Sco2min-ox equal or less than 50% is an independent risk factor for 30-day and 1-yr mortality. Conclusions Preoperative Sco2 levels are reflective of the severity of cardiopulmonary dysfunction, associated with short- and long-term mortality and morbidity, and may add to preoperative risk stratification in patients undergoing cardiac surgery.

scholarly journals High renal regional oxygen saturation in femoral arteriovenous fistula after neonatal cardiac surgery

2015 ◽  
Vol 2015 (feb12 1) ◽  
pp. bcr2014205532-bcr2014205532
Author(s):  
J.-S. Tremblay-Roy ◽  
K. Harrington ◽  
S. Vobecky ◽  
G. Emeriaud
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Arteriovenous Fistula ◽  
Regional Oxygen Saturation ◽  
Neonatal Cardiac Surgery

scholarly journals The Outcomes of Patients Incidentally Confirmed with Covid-19 After Cardiac Surgery

2021 ◽  
Vol 24 (6) ◽  
pp. E940-E946
Author(s):  
Ayhan Uysal ◽  
Esra Erturk ◽  
Ahmet Feyzi Abacilar ◽  
Umit Duman ◽  
Omer Faruk Dogan
Keyword(s):  
Cardiac Surgery ◽  
Oxygen Saturation ◽  
Clinical Outcomes ◽  
Main Role ◽  
Test Results ◽  
Rt Pcr ◽  
Icu Patients ◽  
Transcutaneous Oxygen ◽  
Pcr Test ◽  
D Dimer

Background: The aim of this study was to investigate the clinical outcomes of cardiac surgery in patients who were incidentally diagnosed with Covid-19 in the postoperative period. Patients and methods: We performed 826 open cardiac surgeries in five tertiary centers. Most of the surgeries were elective coronary artery bypass grafting (CABG) (93.8%). A preoperative RT-PCR test and transcutaneous oxygen saturation were routinely investigated prior to surgery. We also investigated whether the patients already received Covid-19 treatment or had any contact with a Covid-19 patient in the last two weeks. We analyzed high sensitive C-reactive protein (hs-CRP), d-dimer, and fibrinogen, which plays a main role in the activation of procoagulant state after surgeries. Results: Acute lung injury related to Covid-19 activation was observed in 48 out of 826 patients (5.8%). The median age of 48 patients was 63.9±12.4 years. Euro-Score and body mass index (BMI) were 6.1±1.1 and 29.2±4.1kg/m², respectively. RT-PCR test results were positive in 29 patients (60.4%). We performed thoracic computed tomography (CT) in all patients with or without positive RT-PCR test results. Thoracic CT images showed that there was a different degree of ARDS (mild, moderate, and serious). The median time of extracorporeal circulation (ECC) was 93.2±14.6 min. in on-pump surgery (IQR, 68-155 min.). Common symptoms included dyspnea (N = 22; 45.8%) and fever (N = 12; 25%). Eleven patients needed readmission to ICU. Compared with non-admitted to ICU patients, ICU patients were higher comorbidities and severe laboratory abnormalities (eg, high blood d-dimer and fibrinogen). We also detected significantly low oxygen saturation, hypercapnia, and severe acidosis in readmitted patients. Radiologic investigations showed that there were severe ARDS with bilateral pneumonic infiltration resistant to medical treatment in 6 out of 11 patients who died (54.5%). Conclusion: Diffuse pneumonic infiltration related to Covid-19 may develop in asymptomatic cardiac surgery patients with negative RT-PCR test results. Immunologic disorders resulting from ECC, physiologic distress, and anesthesia may activate Covid-19 during the incubation period. We need randomized clinical trials to explain Covid-19 activation in the latent period of the virus, and clinical outcomes in cardiac surgery.

Regional oxygen saturation change rate for detection of leg ischemia in minimally invasive cardiac surgery

Perfusion ◽  
2020 ◽  
pp. 026765912094672
Author(s):  
Fumiaki Shikata ◽  
Yoshitsugu Nakamura ◽  
Yasuhito Okuzono ◽  
Yuichi Uchigasaki ◽  
Naoya Yamauchi
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Minimally Invasive ◽  
Oxygen Saturation ◽  
Near Infrared ◽  
Minimally Invasive Cardiac Surgery ◽  
Change Rate ◽  
Regional Oxygen Saturation ◽  
Distal Perfusion ◽  
Leg Ischemia

Introduction: The criteria for placement of distal perfusion cannulas vary among reports. This cohort study aimed to establish a reproducible method to monitor critical leg ischemia during minimally invasive cardiac surgery. Methods: We included 121 patients who underwent minimally invasive cardiac surgery via right thoracotomy with right femoral arterial cannulation from 2015 to 2018. The change rate of regional oxygen saturation (ΔrSO2) was calculated as follows: rSO2 (baseline) − rSO2 (actual number)/rSO2 (baseline). Patients were divided into Group N (ΔrSO2 < 40%): 100/121 (83%) and Group H (ΔrSO2 > 40%, <10 minutes if >40%): 21/121 (17%). A distal perfusion cannula was placed when ΔrSO2 was >40% over 10 minutes. Results: No patients experienced significant leg ischemia. Significantly longer cardiopulmonary bypass and aortic cross-clamp times were observed in Group H than in Group N (cardiopulmonary bypass time, 129 ± 36 minutes (Group N) vs. 151 ± 34 minutes (Group H), p = 0.01). ΔrSO2 correlated positively with plasma creatine phosphokinase elevation (R = 0.40, p < 0.001) on postoperative day 1. Serum lactate on intensive care unit admission showed a significant positive correlation (R = 0.40, p < 0.001) with ΔrSO2. Conclusion: ΔrSO2 measurement by near-infrared spectroscopy can facilitate distal leg perfusion monitoring and assist surgeons in preventing critical leg ischemia during minimally invasive cardiac surgery.

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