Combined central venous oxygen saturation and lactate as markers of occult hypoperfusion and outcome following cardiac surgery

Journal of Cardiothoracic and Vascular Anesthesia

Volumn 26, Issue 1, 2012, Pages 52-57

  Hu, BeeBee Y ^a   Laine, Greg A ^a   Wang, Suwei ^a,b   Solis, R Thomas ^a,c  

^a ST LUKE S EPISCOPAL HOSPITAL   (United States)

^b TEXAS HEART INSTITUTE   (United States)

^c BAYLOR COLLEGE OF MEDICINE   (United States)

Author keywords

central venous oxygen saturation; global tissue hypoxia; lactate; occult hypoperfusion; postcardiac surgery care; postoperative complications

Indexed keywords

LACTIC ACID;

ADULT; ADULT RESPIRATORY DISTRESS SYNDROME; AGED; ARTICLE; ARTIFICIAL VENTILATION; CARDIOGENIC SHOCK; CENTRAL VENOUS OXYGEN SATURATION; CENTRAL VENOUS PRESSURE; CORONARY ARTERY BYPASS GRAFT; DISEASE SEVERITY; FEMALE; GLOBAL TISSUE HYPOXIA; HEART ARREST; HEART SURGERY; HEART VALVE SURGERY; HOSPITAL ADMISSION; HUMAN; HYPOXEMIA; INTENSIVE CARE UNIT; KIDNEY DYSFUNCTION; KIDNEY FAILURE; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORBIDITY; OBSERVATIONAL STUDY; OCCULT HYPOPERFUSION; OXYGEN SATURATION; PERFUSION; POSTOPERATIVE INFECTION; PRIORITY JOURNAL; PROSPECTIVE STUDY; SEPSIS; TERTIARY HEALTH CARE; TREATMENT OUTCOME; URINE VOLUME;

AGED; ANOXIA; BIOLOGICAL MARKERS; CARDIAC SURGICAL PROCEDURES; CATHETERIZATION, CENTRAL VENOUS; FEMALE; HUMANS; LACTIC ACID; MALE; MIDDLE AGED; OXYGEN; OXYGEN CONSUMPTION; POSTOPERATIVE COMPLICATIONS; PROSPECTIVE STUDIES; TISSUE DISTRIBUTION; TREATMENT OUTCOME;

EID: 84855322643     PISSN: 10530770     EISSN: 15328422     Source Type: Journal    
DOI: 10.1053/j.jvca.2011.07.021     Document Type: Article

References (36)

1. Shoemaker WC, Appel PL, Kram HB: Role of oxygen debt in the development of organ failure sepsis, and death in high-risk surgical patients. Chest 102:208-215, 1992
2. Beal AL, Cerra FB: Multiple organ failure syndrome in the 1990s. Systemic inflammatory response and organ dysfunction. JAMA 271:226-233, 1994 (Pubitemid 24041262)
3. Marshall JC: Inflammation, coagulopathy, and the pathogenesis of multiple organ dysfunction syndrome. Crit Care Med 29:S99-106, 2001
4. Rivers E, Nguyen B, Havstad S, et al: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368-1377, 2001
5. Rady MY, Rivers EP, Nowak RM: Resuscitation of the critically ill in the ED: Responses of blood pressure, heart rate, shock index, central venous oxygen saturation, and lactate. Am J Emerg Med 14:218-225, 1996 (Pubitemid 26090212)
6. St André AC, DelRossi A: Hemodynamic management of patients in the first 24 hours after cardiac surgery. Crit Care Med 33:2082-2093, 2005 (Pubitemid 41306534)
7. Scalea TM, Maltz S, Yelon J, et al: Resuscitation of multiple trauma and head injury: Role of crystalloid fluids and inotropes. Crit Care Med 22:1610-1615, 1994 (Pubitemid 24320885)
8. Scalea TM, Holman M, Fuortes M, et al: Central venous blood oxygen saturation: An early, accurate measurement of volume during hemorrhage. J Trauma 28:725-732, 1988
9. Reinhart K, Rudolph T, Bredle DL, et al: Comparison of centralvenous to mixed-venous oxygen saturation during changes in oxygen supply/demand. Chest 95:1216-1221, 1989 (Pubitemid 19160143)
10. Pearse RM, Rhodes A: Mixed and central venous oxygen saturation, in Vincent JL (ed): Yearbook of Intensive Care and Emergency Medicine. Berlin, Germany, Springer, 2005, pp 592-602
11. Scalea TM, Hartnett RW, Duncan AO, et al: Central venous oxygen saturation: A useful clinical tool in trauma patients. J Trauma 30:1539-1543, 1990
12. Friedman G, De Backer D, Shahla M, et al: Oxygen supply dependency can characterize septic shock. Intensive Care Med 24:118-123, 1998 (Pubitemid 28190762)
13. Bakker J, Coffernils M, Leon M, et al: Blood lactate levels are superior to oxygen-derived variables in predicting outcome in human septic shock. Chest 99:956-962, 1991
14. Kern JW, Shoemaker WC: Meta-analysis of hemodynamic optimization in high-risk patients. Crit Care Med 30:1686-1692, 2002 (Pubitemid 34879575)
15. Lobo SM, Lobo FR, Polachini CA, et al: Prospective, randomized trial comparing fluids and dobutamine optimization of oxygen delivery in high-risk surgical patients [ISRCTN42445141]. Crit Care 10:R72, 2006
16. Pölönen P, Ruokonen E, Hippeläinen M, et al: A prospective, randomized study of goal-oriented hemodynamic therapy in cardiac surgical patients. Anesth Analg 90:1052-1059, 2000 (Pubitemid 30253449)
17. Elliott DC: An evaluation of the end points of resuscitation. J Am Coll Surg 187:536-547, 1998
18. Ryan TA, Rady MY, Bashour CA, et al: Predictors of outcome in cardiac surgical patients with prolonged intensive care stay. Chest 112:1035-1042, 1997 (Pubitemid 27446326)
19. Christakis GT, Fremes SE, Naylor CD, et al: Impact of preoperative risk and perioperative morbidity on ICU stay following coronary bypass surgery. Cardiovasc Surg 4:29-35, 1996 (Pubitemid 26027250)
20. Ghotkar SV, Grayson AD, Fabri BM, et al: Preoperative calculation of risk for prolonged intensive care unit stay following coronary artery bypass grafting. J Cardiothorac Surg 1:14-21, 2006
21. Jakob SM, Parviainen I, Bracht H: Multicentre study on periand postoperative central venous oxygen saturation in high-risk surgical patients. Crit Care 10:R158-R165, 2006
22. Pearse R, Dawson D, Fawcett J, et al: Changes in central venous saturation after major surgery, and association with outcome. Crit Care 9:R694-R699, 2005
23. Maillet JM, Le Besnerais P, Cantoni M, et al: Frequency, risk factors, and outcome of hyperlactatemia after cardiac surgery. Chest 123:1361-1366, 2003 (Pubitemid 36549750)
24. Rivers EP, Kruse JA, Jacobsen G, et al: The influence of early hemodynamic optimization on biomarker patterns of severe sepsis and septic shock. Crit Care Med 35:2016-2024, 2007 (Pubitemid 47326436)
25. Marshall JC, Cook DJ, Christou NV, et al: Multiple organ dysfunction score: A reliable descriptor of a complex clinical outcome. Crit Care Med 23:1638-1652, 1995
26. Altman DG: How large a sample?, in Gor SM, Altman DG (eds): Statistics in Practice. London, UK, British Medical Association, 1982
27. Trzeciak S, De Backer D: Modulation of the sepsis inflammatory response by resuscitation: The missing link between cytopathic and hypoxic hypoxia? Crit Care Med 35:2206-2207, 2007 (Pubitemid 47326462)
28. Huang YC: Monitoring oxygen delivery in the critically ill. Chest 128:554S-560S, 2005
29. Reinhart K, Kuhn HJ, Hartog C, et al: Continuous central venous and pulmonary artery oxygen saturation monitoring in the critically ill. Intensive Care Med 30:1572-1578, 2004 (Pubitemid 39094958)
30. Meregalli A, Oliveira RP, Friedman G: Occult hypoperfusion is associated with increased mortality in hemodynamically stable, highrisk, surgical patients. Crit Care 8:R60-R65, 2004
31. Routsi C, Vincent JL, Bakker J, et al: Relation between oxygen consumption and oxygen delivery in patients after cardiac surgery. Anesth Analg 77:1104-1110, 1993 (Pubitemid 23355195)
32. Pearse R, Dawson D, Fawcett J, et al: Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCTN38797445]. Crit Care 9:R687-R693, 2005
33. Shoemaker WC, Wo CC, Thangathurai D, et al: Hemodynamic patterns of survivors and nonsurvivors during high risk elective surgical operations. World J Surg 23:1264-1271, 1999 (Pubitemid 29530472)
34. Ranucci M, Isgrò G, Carlucci C, et al: Central venous oxygen saturation and blood lactate levels during cardiopulmonary bypass are associated with outcome after pediatric cardiac surgery. Crit Care 14:R149, 2010
35. Totaro RJ, Raper RF: Epinephrine-induced lactic acidosis following cardiopulmonary bypass. Crit Care Med 25:1693-1699, 1997 (Pubitemid 27435505)
36. Raper RF, Cameron G, Walker D, et al: Type B lactic acidosis following cardiopulmonary bypass. Crit Care Med 25:46-51, 1997