Osguthorpe S G, Tidwell S L, Ryan W J, Paull D L, Smith T L
Virginia Mason Medical Center, Seattle, Wash.
Heart Lung. 1990 Sep;19(5 Pt 2):570-4.
Ensuring adequate oxygen delivery to the tissues with respect to oxygen demand is the treatment goal in patients undergoing coronary artery surgery (CAS). In this study we examined changes in temperature, arterial oxygen saturation (SaO2), cardiac index (CI), oxygen consumption (VO2), and mixed venous oxygen saturation (SvO2) over the initial 4-hour rewarming period in 36 patients having CAS. When patients were admitted to the intensive care unit the mean temperature was 36.27 degrees C, and it increased to 37.50 degrees C; SaO2 was 97.67% at the beginning and end of the 4-hour period; CI was 2.88 L/min/m2 and rose to 3.00 L/min/m2; VO2 was high at 0.320 L/min on admission and remained high at 0.290 L/min at the end of the 4-hour rewarming period; and SvO2 was 70.83% initially and declined to 66.53% in the same period of time. Continuous SvO2 monitoring was valuable in the ongoing assessment and management of the patients in stable, mildly hypothermic condition after CAS during the 4-hour postoperative rewarming period.
根据氧气需求确保向组织提供充足的氧气是接受冠状动脉手术(CAS)患者的治疗目标。在本研究中,我们检查了36例接受CAS患者在最初4小时复温期内体温、动脉血氧饱和度(SaO2)、心脏指数(CI)、氧耗量(VO2)和混合静脉血氧饱和度(SvO2)的变化。当患者入住重症监护病房时,平均体温为36.27摄氏度,随后升至37.50摄氏度;4小时期间开始和结束时的SaO2均为97.67%;CI为2.88升/分钟/平方米,并升至3.00升/分钟/平方米;入院时VO2较高,为0.320升/分钟,在4小时复温期结束时仍较高,为0.290升/分钟;SvO2最初为70.83%,在同一时间段内降至66.53%。在术后4小时复温期,持续监测SvO2对于持续评估和管理处于稳定、轻度低温状态的CAS术后患者非常有价值。