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- Title
Mixed venous oxygen desaturation during early mobilization after coronary artery bypass surgery.
- Authors
Kirkeby-Garstad, I.; Sellevold, O. F. M.; Stenseth, R.; Skogvoll, E.
- Abstract
Early postoperative mobilization induces a marked reduction in mixed venous oxygen saturation (SvO2) after aortic valve replacement. We investigated whether a similar desaturation occurs among coronary artery bypass grafting (CABG) patients, and if the desaturation was related to the preoperative ejection fraction (EF). Thirty-one CABG patients with a wide range in EF were included in an open observational study. We recorded hemodynamic and oxygenation variables during mobilization on postoperative day 1 and day 2 using a pulmonary artery catheter. Patients with an EF ranging from 24 to 87% were mobilized without clinical problems. SvO2 at rest was 65.4 ± 4.9% (mean ± SD) on day 1 and 64.3 ± 5.8% on day 2 (NS). During mobilization, cardiac index and oxygen delivery were reduced while oxygen consumption was increased ( P-values: 0.000, 0.007 and 0.000, respectively). Consequently, oxygen extraction increased, resulting in a marked reduction in SvO2−42.9 ± 8.3% on day 1 and 47.4 ± 8.5% on day 2 ( P = 0.025 between days). Several pre-, intra- and postoperative factors were tested as possible predictors for SvO2 during mobilization. No factor contributed substantially. Patients with CABG exhibit a marked desaturation during early postoperative mobilization. Preoperative ejection fraction did not affect SvO2 during exercise. The clinical consequences and underlying mechanism require further investigation.
- Subjects
OXYGEN; CORONARY arteries; CATHETERS; CORONARY artery bypass; MYOCARDIAL revascularization; HEART blood-vessels
- Publication
Acta Anaesthesiologica Scandinavica, 2005, Vol 49, Issue 6, p827
- ISSN
0001-5172
- Publication type
Article
- DOI
10.1111/j.1399-6576.2005.00617.x