Marked mixed venous desaturation during early mobilization after aortic valve surgery.

Abstract:

UNLABELLED:We investigated the physiological reaction to mobilization the first and second day after aortic valve replacement in an open, prospective study. Hemodynamic and oxygenation variables were recorded in 15 patients using a pulmonary artery oximetry catheter and bench oximetry. Serious intraoperative events occurred in 3 patients, but all patients began mobilization on the first postoperative day and mobilization was accomplished without clinical problems. Mixed venous oxygen saturation (SvO(2)) at rest was 58.0 +/- 7.7% (mean +/- SD) on the first postoperative day and 58.0 +/- 6.2% on the second day (NS). During mobilization, oxygen consumption increased by 64 +/- 41% and 58 +/- 33% on the first and second days (P < 0.01; NS between days). No compensatory increase in cardiac index and oxygen delivery was seen. Oxygen extraction increased, resulting in SvO(2) values during exercise of 35.7 +/- 6.8% on the first day and 36.7 +/- 7.7% on the second day (P < 0.01; NS between days), whereas mixed venous oxygen partial pressure was 3.0 +/- 0.4 kPa on both days. The lowest recorded value for SvO(2) was 10%. The marked and consistent mixed venous desaturation during early mobilization has not been described before and the clinical consequences and underlying mechanism require further investigation. IMPLICATIONS:During early mobilization after aortic valve replacement, a marked and consistent reduction in mixed venous oxygen saturation to 35% and mixed venous oxygen partial pressure to 3 kPa was observed.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Kirkeby-Garstad I,Sellevold OF,Stenseth R,Skogvoll E,Karevold A

doi

10.1213/01.ane.0000096194.10459.7e

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

311-7, table of contents

issue

2

eissn

0003-2999

issn

1526-7598

journal_volume

98

pub_type

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