Yoshitake A, Goto T, Baba T, Shibata Y
Department of Anesthesiology, Kumamoto Chuo Hospital, Kumamoto City, Japan.
J Cardiothorac Vasc Anesth. 1999 Apr;13(2):160-4. doi: 10.1016/s1053-0770(99)90080-0.
To investigate preoperative clinical conditions and/or intraoperative physiologic variables related to jugular venous oxygen saturation (SjO2) during cardiopulmonary bypass (CPB).
Prospective study.
General hospital, single institution.
One hundred forty patients (52 women, 88 men) who underwent coronary artery bypass grafting.
The authors measured SjO2 at five times during surgery. Multiple stepwise regression analysis showed a significant correlation of SjO2 with (1) arterial carbon dioxide partial pressure (PaCO2) before CPB (standard regression coefficient [(SC)] = 0.435), (2) cerebral perfusion pressure (CPP) during initiation of CPB (SC = 0.259), (3) PaCO2, tympanic temperature (TT), bubble oxygenator, and cerebral small infarctions (CSIs) during hypothermic CPB (SC = 0.507, -0.237, -0.192, and -0.189, respectively), (4) CPP, PaCO2, CSIs, and bubble oxygenator during rewarming (SC = 0.476, 0.294, -0.220, and -0.189, respectively), and (5) PaCO2 after CPB (SC = 0.480; p < 0.01). Correlation coefficients between SjO2 and CPP during rewarming were 0.40 (0.46 without CSI and 0.37 with CSI; p < 0.01). These results indicate that the relationship between CPP and SjO2 was significant in patients with CPP less than 40 mmHg during rewarming.
During rewarming, when cerebral perfusion and oxygen demand change abruptly, but not during stable hypothermic CPB, CPP was a significant factor related to sjO2.
