Autor(es):
Miranda, César de Araujo ; Meletti, José F.A. ; Lima, Laís H.N. [UNESP] ; Marchi, Evaldo
Data: 2020
Identificador Persistente: http://hdl.handle.net/11449/200962
Origem: Oasisbr
Assunto(s): Blood gas analyses; Cardiac surgery procedures; Mortality; Perioperative care; Venous catheterization; Blood gas analyses; Blood gas analyses; Cardiac surgery procedures; Cardiac surgery procedures; Mortality; Mortality; Perioperative care; Perioperative care; Venous catheterization; Venous catheterization
Descrição
Made available in DSpace on 2020-12-12T02:20:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01
Background: Cardiac surgery can produce persistent deficit in the ratio of Oxygen Delivery (DO2) to Oxygen Consumption (VO2). Central venous oxygen Saturation (ScvO2) is an accessible and indirect measure of DO2/VO2 ratio. Objective: To monitor perioperative ScvO2 and assess its correlation with mortality during cardiac surgery. Methods: This prospective observational study evaluated 273 patients undergoing cardiac surgery. Blood gas samples were collected to measure ScvO2 at three time points: T0 (after anesthetic induction), T1 (end of surgery), and T2 (24 hours after surgery). The patients were divided into two groups (survivors and nonsurvivors). The following outcomes were analyzed: intrahospital mortality, length of Intensive Care Unit (ICU) and hospital stay (LOS), and variation in ScvO2. Results: Of the 273 patients, 251 (92%) survived and 22 (8%) did not. There was a significant perioperative reduction of ScvO2 in both survivors (T0 = 78% ± 8.1%, T1 = 75.4% ± 7.5%, and T2 = 68.5% ± 9%; p < 0.001) and nonsurvivors (T0 = 74.4% ± 8.7%, T1 = 75.4% ± 7.7%, and T2 = 66.7% ± 13.1%; p < 0.001). At T0, the percentage of patients with ScvO2 < 70% was greater in the nonsurvivor group (31.8% vs. 13.1%; p = 0.046) and the multiple logistic regression showed that ScvO2 is an independent risk factor associated with death, OR = 2.94 (95% CI 1.10 − 7.89) (p = 0.032). The length of ICU and LOS were 3.6 ± 3.1 and 7.4 ± 6.0 days respectively and was not significantly associated with ScvO2. Conclusions: Early intraoperative ScvO2 < 70% indicated a higher risk of death. A perioperative reduction of ScvO2 was observed in patients undergoing cardiac surgery, with high intraoperative and lower postoperative levels.
Faculdade de Medicina de Jundiaí Disciplina de Anestesiologia
Universidade Estadual Paulista (UNESP) Faculdade de Medicina de Botucatu Departamento de Anestesiologia
Faculdade de Medicina de Jundiaí
Universidade Estadual Paulista (UNESP) Faculdade de Medicina de Botucatu Departamento de Anestesiologia
